Hepatitis C therapy with grazoprevir/elbasvir and glecaprevir/pibrentasvir in patients with advanced chronic kidney disease: data from the German Hepatitis C-Registry (DHC-R)

被引:7
作者
Stein, Kerstin [1 ]
Stoehr, Albrecht [2 ]
Klinker, Hartwig [3 ]
Teuber, Gerlinde [4 ]
Naumann, Uwe [5 ]
John, Christine [6 ]
Heyne, Renate [7 ]
Serfert, Yvonne [8 ]
Niederau, Claus [9 ]
Zeuzem, Stefan [10 ]
Berg, Thomas [11 ]
Wiegand, Johannes [11 ]
机构
[1] Hepatol Magdeburg, Magdeburg, Germany
[2] IFI Inst Interdisciplinary Med, Hamburg, Germany
[3] Univ Hosp Wurzburg, Dept Med 2, Wurzburg, Germany
[4] Practice PD Dr Med G Teuber, Frankfurt, Germany
[5] UBN Praxis, Berlin, Germany
[6] Ctr Gastroenterol, Berlin, Germany
[7] Leberzentrum Checkpoint, Berlin, Germany
[8] Leberstiftungs GmbH Deutschland, Hannover, Germany
[9] St Josef Hosp Oberhausen, Dept Internal Med, Frankfurt, Germany
[10] Univ Hosp Frankfurt, Dept Med 1, Frankfurt, Germany
[11] Univ Leipzig, Dept Med 2, Div Hepatol, Med Ctr, Leipzig, Germany
关键词
effectiveness; liver cirrhosis; real-life; safety; SVR12; VIRUS GENOTYPE 1; HEMODIALYSIS-PATIENTS; DIALYSIS PATIENTS; TREATMENT-NAIVE; INFECTION; RISK; ELBASVIR;
D O I
10.1097/MEG.0000000000001923
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Objectives Grazoprevir/elbasvir and glecaprevir/pibrentasvir (G/P) are the two preferred treatment options for patients with chronic hepatitis C virus (HCV) infection and a glomerular filtration rate (GFR) <30 mL/min. Both therapies have been separately analyzed in different real-life cohorts; however, a direct comparison has not been performed so far. We, therefore, analyzed safety and effectiveness of both regimens in a concerted real-life population. Methods The Germany Hepatitis C-Registry is a prospective national real-world registry. The analysis is based on 2773 patients with documented GFR at baseline treated with grazoprevir/elbasvir (N = 1041), grazoprevir/elbasvir + ribavirin (N = 53) and glecaprevir/pibrentasvir (N = 1679). Results A total of 93 patients with GFR <30 mL/min were treated with grazoprevir/elbasvir (N = 56), grazoprevir/elbasvir + ribavirin (N = 4), and glecaprevir/pibrentasvir (N = 33). They suffered significantly more frequent from diabetes mellitus, hypertension, and coronary heart disease than individuals with GFR >30 mL/min and showed the following baseline characteristics: 20.4, 55.9, 3.2, 12.9, and 5.3% were infected with HCV-genotypes 1a, 1b, 2, 3, and 4; 12.9% suffered from liver cirrhosis; 80.1% were treatment-naive. Baseline characteristics except distribution of HCV-genotype 1b (n = 43/52 treated with grazoprevir/elbasvir) and sustained virologic response rates (SVR12) did not differ significantly between glecaprevir/pibrentasvir (SVR12: 100%) and grazoprevir/elbasvir (SVR12: 97.9%). Fatigue, headache, abdominal discomfort, and arthralgia were the most frequently reported adverse events without a statistical difference between grazoprevir/elbasvir and glecaprevir/pibrentasvir. Conclusion In patients with chronic hepatitis C and a baseline GFR <= 30 mL/min grazoprevir/elbasvir and glecaprevir/pibrentasvir show an equally favorable safety profile and antiviral efficacy and can both be recommended for real-life use.
引用
收藏
页码:76 / 83
页数:8
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