奈玛特韦片/利托那韦片组合包装治疗肝硬化患者新型冠状病毒肺炎的临床疗效

Clinical effectiveness of nirmatrelvir plus ritonavir in the treatment of COVID-19 in patients with cirrhosis.

作者信息

Hsu Wan-Hsuan, Shiau Bo-Wen, Liu Ting-Hui, Wu Jheng-Yan, Tsai Ya-Wen, Huang Po-Yu, Chuang Min-Hsiang, Lai Chih-Cheng, Chen Chi-Hsing

机构信息

Department of Internal Medicine, Chi Mei Medical Center, Tainan, Taiwan.

Divison of General Medicine, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.

出版信息

Expert Rev Anti Infect Ther. 2023 Jul-Dec;21(10):1143-1151. doi: 10.1080/14787210.2023.2267846. Epub 2023 Oct 27.

DOI:10.1080/14787210.2023.2267846

PMID:37795869

Abstract

OBJECTIVES

This retrospective cohort study assessed the clinical effectiveness of nirmatrelvirplus ritonavir (NMV-r) in treating COVID-19 in patients with liver cirrhosis(LC).

METHODS

The data of non-hospitalized adult patients with LC who had COVID-19 were selected from the TriNetX platform for the period between 1 March 20201 March 2020, and 31 December 202231 December 2022. Propensity score matching was used to match patients receiving NMV-r (theNMV-r group) with those not receiving NMV-r (the control group). Hazard ratios(HRs) along with 95% confidence intervals (CIs) for the primary outcome - a composite of all-cause hospitalization or mortality during the 30-day follow-up period - were calculated and compared.

RESULTS

Two cohorts of 2,369 patients each with balanced baseline characteristics were identified.During the follow-up period, the NMV-r group had a lower risk of all-cause hospitalization or mortality (HR, 0.642;95% CI, 0.503-0.819) than did the control group.NMV-r was also associated with a reduced risk of individual all-cause hospitalization (HR 0.681, 95% CI 0.530-0.876])and all-cause mortality (HR, 0.270; 95% CI,0.129-0.562). This association was consistently observed in the subgroups of age, sex, vaccination status, and LC severity.

CONCLUSIONS

NMV-r can reduce all-cause hospitalization and mortality among patients with LC who have COVID-19.

摘要

目的

本回顾性队列研究评估了奈玛特韦片/利托那韦片（NMV-r）治疗肝硬化（LC）患者新型冠状病毒肺炎（COVID-19）的临床疗效。

方法

选取2020年3月1日至2022年12月31日期间在TriNetX平台上的非住院成年LC合并COVID-19患者的数据。采用倾向评分匹配法将接受NMV-r治疗的患者（NMV-r组）与未接受NMV-r治疗的患者（对照组）进行匹配。计算并比较主要结局（30天随访期内全因住院或死亡的综合指标）的风险比（HR）及95%置信区间（CI）。

结果

确定了两组各2369例基线特征均衡的患者。在随访期间，NMV-r组全因住院或死亡风险低于对照组（HR=0.642，95%CI：0.503-0.819）。NMV-r还与个体全因住院风险降低（HR=0.681，95%CI：0.530-0.876）和全因死亡风险降低（HR=0.270，95%CI：0.129-0.562）相关。在年龄、性别、疫苗接种状况和LC严重程度亚组中均观察到这种关联。