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Effectiveness and safety of elbasvir/grazoprevir in Korean patients with hepatitis C virus infection: a nationwide real-world study

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Background/Aim: This study aimed to establish the real-world effectiveness and safety of grazoprevir/elbasvir (EBR/GZR) therapy in South Korea. Methods: A total of 242 patients with chronic hepatitis C virus (HCV) genotype 1 or 4 infection who started EBR/GZR were consecutively enrolled from seven tertiary hospitals. Retrospective analysis of the fractions of patients that achieved sustained virological response (SVR) was performed, and the incidence of adverse events was noted. Results: The mean age of enrolled patients was 59.0 ± 12.6 years and 47.5% were males. Patients with HCV genotype 1b accounted for 93.8% (n = 227), and patients with HCV of unspecified genotype 1 accounted for 5.8% (n = 14). Hypertension was the most common comorbid disease (29.8%) followed by diabetes (22.7%) and chronic kidney disease (CKD, 12.4%). SVR rates of treatment-naïve and treatment- experienced patients were 85.5% (182/213) and 93.1% (27/29), respectively, in the intention-to-treat analyses, whereas in the per-protocol analyses, those were 97.8% (179/183) and 100% (28/28), respectively. Fewer patients with HCV genotype 1 of unspecified subtype achieved SVR (81.8%, n = 11) compared to the patients with SVR infected with genotype 1b (99%, n = 198, p < 0.001). All patients with CKD showed SVR. Itching (12%) and dyspepsia (4.1%) were common adverse events. Of the four patients who discontinued the antiviral therapy, one experienced mild fatigue but neither treatment withdrawal was because of an adverse event. Conclusions: EBR/GZR showed high real-world effectiveness and safety in Korean patients with chronic HCV infection regardless of the previous antiviral treatment, liver cirrhosis, or CKD status.

Abstract

Background/Aim: This study aimed to establish the real-world effectiveness and safety of grazoprevir/elbasvir (EBR/GZR) therapy in South Korea. Methods: A total of 242 patients with chronic hepatitis C virus (HCV) genotype 1 or 4 infection who started EBR/GZR were consecutively enrolled from seven tertiary hospitals. Retrospective analysis of the fractions of patients that achieved sustained virological response (SVR) was performed, and the incidence of adverse events was noted. Results: The mean age of enrolled patients was 59.0 ± 12.6 years and 47.5% were males. Patients with HCV genotype 1b accounted for 93.8% (n = 227), and patients with HCV of unspecified genotype 1 accounted for 5.8% (n = 14). Hypertension was the most common comorbid disease (29.8%) followed by diabetes (22.7%) and chronic kidney disease (CKD, 12.4%). SVR rates of treatment-naïve and treatment- experienced patients were 85.5% (182/213) and 93.1% (27/29), respectively, in the intention-to-treat analyses, whereas in the per-protocol analyses, those were 97.8% (179/183) and 100% (28/28), respectively. Fewer patients with HCV genotype 1 of unspecified subtype achieved SVR (81.8%, n = 11) compared to the patients with SVR infected with genotype 1b (99%, n = 198, p < 0.001). All patients with CKD showed SVR. Itching (12%) and dyspepsia (4.1%) were common adverse events. Of the four patients who discontinued the antiviral therapy, one experienced mild fatigue but neither treatment withdrawal was because of an adverse event. Conclusions: EBR/GZR showed high real-world effectiveness and safety in Korean patients with chronic HCV infection regardless of the previous antiviral treatment, liver cirrhosis, or CKD status.

참고문헌 (26)

  1. Franco E, "The evolution of the burden of viral hepatitis from 1990 to 2013 : still an open challenge to global public health policy", Hepatobiliary Surg Nutr, 6, pp.277~279 (2017)
  2. Stanaway JD, "The global burden of viral hepatitis from 1990 to 2013 : findings from the Global Burden of Disease Study 2013", Lancet, 388, pp.1081~1088 (2016)
  3. Heffernan A, "Scaling up prevention and treatment towards the elimination of hepatitis C : a global mathematical model", Lancet, 393, pp.1319~1329 (2019)
  4. Kim DY, "A nationwide seroepidemiology of hepatitis C virus infection in South Korea", Liver Int, 33, pp.586~594 (2013)
  5. Sang Soo Lee, "Type and cause of liver disease in Korea: single-center experience, 2005-2010", Clinical and Molecular Hepatology, 18(3), pp.309~315 (2012), 대한간학회[DOI]
  6. Jacobson IM, "Safety and efficacy of elbasvir", grazoprevir in patients with hepatitis C virus infection and compensated cirrhosis : an integrated analysis, 2017, pp.152, 1372~1382
  7. Zeuzem S, "Grazoprevir-elbasvir combination therapy for treatment-naive cirrhotic and noncirrhotic patients with chronic hepatitis C virus genotype 1, 4, or 6 infection : a randomized trial", Ann Intern Med, 163, pp.1~13 (2015)
  8. Sulkowski M, "Efficacy and safety of 8 weeks versus 12 weeks of treatment with grazoprevir(MK-5172)and elbasvir(MK-8742)with or without ribavirin in patients with hepatitis C virus genotype 1mono-infection and HIV", hepatitis C virus co-infection(C-WORTHY) : a randomised, open-label phase 2 trial, 2015, pp.385, 1087~1097
  9. Su F, "The association between race", ethnicity and the effectiveness of direct antiviral agents for hepatitis C virus infection, 2017, pp.65, 426~438
  10. Benhammou JN, "Race affects SVR12 in a large and ethnically diverse hepatitis C-infected patient population following treatment with direct-acting antivirals : analysis of a single-center Department of Veterans Affairs cohort", Pharmacol Res Perspect, 6, pp.e00379~ (2018)
  11. Wei L, "Safety and efficacy of elbasvir", grazoprevir in Asian participants with hepatitis C virus genotypes 1 and 4 infection, 2019, pp.34, 1597~1603
  12. Youn Jae Lee, "An integrated analysis of elbasvir", grazoprevir in Korean patients with hepatitis C virus genotype 1b infection, 2019, pp.25(4), 400~407[DOI]
  13. Suk KT, "Revision and update on clinical practice guideline for liver cirrhosis", Korean J Hepatol, 18, pp.1~21 (2012)
  14. Levey AS, "A more accurate method to estimate glomerular filtration rate from serum creatinine : a new prediction equation. Modification of Diet in Renal Disease Study Group", Ann Intern Med, 130, pp.461~470 (1999)
  15. The Korean Association for the Study of the Liver, "KASL clinical practice guidelines for liver cirrhosis: Ascites and related complications", Clinical and Molecular Hepatology, 24(3), pp.169~229 (2018), 대한간학회
  16. Mashiba T, "Real-world efficacy of elbasvir and grazoprevir for hepatitis C virus(genotype 1) : a nationwide, multicenter study by the Japanese Red Cross Hospital Liver Study Group", Hepatol Res, 49, pp.1114~1120 (2019)
  17. Jacobson IM, "Elbasvir", Grazoprevir in people with hepatitis C genotype 1 infection and child-pugh class B cirrhosis : the C-SALT Study, 2019, pp.10, e00007~
  18. Hernandez-Conde M, "Effectiveness and safety of elbasvir", grazoprevir therapy in patients with chronic HCV infection : results from the Spanish HEPA-C real-world cohort, 2019, pp.26, 55~64
  19. Zamor PJ, "Elbasvir", grazoprevir in black adults with hepatitis C virus infection : a pooled analysis of phase 2, Am J Gastroenterol, pp.2018, 113[DOI]
  20. Hedskog C, "Identification of 19novel hepatitis C virus subtypes-further expanding HCV classification", Open Forum Infect Dis, 6, pp.ofz076~ (2019)
  21. Jang ES, "The change in the nationwide seroprevalence of hepatitis C virus and the status of linkage to care in South Korea from 2009 to 2015", Hepatol Int, 13, pp.599~608 (2019)
  22. Ogawa E, "Elbasvir plus grazoprevir for patients with chronic hepatitis C genotype 1 : a multicenter, real-world cohort study focusing on chronic kidney disease", Antiviral Res, 159, pp.143~152 (2018)
  23. Kramer JR, "Real-world effectiveness of elbasvir", grazoprevir In HCV-infected patients in the US veterans affairs healthcare system, 2018, pp.25, 1270~1279
  24. Kumada H, "The combination of elbasvir and grazoprevir for the treatment of chronic HCV infection in Japanese patients : a randomized phase II", III study, 2017, pp.52, 520~533
  25. Lawitz E, "Efficacy and safety of 12 weeks versus 18 weeks of treatment with grazoprevir(MK-5172)and elbasvir(MK-8742)with or without ribavirin for hepatitis C virus genotype 1 infection in previously untreated patients with cirrhosis and patientswith previous null response with or without cirrhosis(C-WORTHY) : a randomised, open-label phase 2 trial", Lancet, 385, pp.1075~1086 (2015)
  26. "Product Information. Zepatier (elbasvir-grazoprevir)" (2017)[URL]

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