Evolution of eGFR in chronic HCV patients receiving sofosbuvir-based or sofosbuvir-free direct-acting antivirals
Data regarding the nephrotoxicity of sofosbuvir (SOF) remain controversial. We compared the evolution of estimated glomerular filtration rate (eGFR) in patients with chronic HCV infection receiving SOF-based or SOF-free direct-acting antivirals (DAAs). A total of 481 patients with compensated liver...
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| Veröffentlicht in: | Journal of hepatology 2020-05, Vol.72 (5), p.839-846 |
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| creator | Liu, Chen-Hua Lee, Mei-Hsuan Lin, Jou-Wei Liu, Chun-Jen Su, Tung-Hung Tseng, Tai-Chung Chen, Pei-Jer Chen, Ding-Shinn Kao, Jia-Horng |
| description | Data regarding the nephrotoxicity of sofosbuvir (SOF) remain controversial. We compared the evolution of estimated glomerular filtration rate (eGFR) in patients with chronic HCV infection receiving SOF-based or SOF-free direct-acting antivirals (DAAs).
A total of 481 patients with compensated liver diseases and eGFR ≥30 ml/min/1.73m2, receiving SOF-based (n = 308) or SOF-free (n = 173) DAAs for 12 weeks, were prospectively enrolled. The eGFR was assessed from baseline to off-treatment week 24 using the chronic kidney disease (CKD)-epidemiology collaboration equation. Differences in the evolution of eGFR between regimens were compared by a generalized linear mixed-effects model. Multivariate analysis was performed for factors affecting eGFR evolution.
Patients receiving SOF-based DAAs experienced a significant on-treatment decline in eGFR (adjusted slope coefficient difference: −1.24 ml/min/1.73m2/month; 95% CI −1.35 to −1.13; p |
| doi_str_mv | 10.1016/j.jhep.2019.11.014 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_journals_2432558882</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0168827819307019</els_id><sourcerecordid>2432558882</sourcerecordid><originalsourceid>FETCH-LOGICAL-c450t-9276b3dc54865ef59ad539557d9671508d664a63f90e0fa8af6c73f8e21b9ab3</originalsourceid><addsrcrecordid>eNp9kNFK5TAQhsPish7dfYG9kIDXrZO2SRPwRg4eFQRBZG9Dmk7WFG1q0h7w7c3hqHjl1cDw_f8wHyF_GZQMmDgbyuERp7ICpkrGSmDND7JiAqAA0bADssqQLGTVykNylNIAADWo5hc5rFmroBViRabLbXhaZh9GGhzFq8099SO1jzGM3tLr9T86mdnjOCca0aLf-vE_TcGF1C1bH4vOJOxpiF93LiLS3md-LoyddwkzzjkazVP6TX66PPDP-zwmD5vLh_V1cXt3dbO-uC1sw2EuVNWKru4tb6Tg6LgyPa8V522vRMs4yF6IxojaKUBwRhonbFs7iRXrlOnqY3K6r51ieFkwzXoISxzzRV01dcW5lLLKVLWnbAwpRXR6iv7ZxFfNQO8c60HvHOudY82Yzo5z6OS9eumesf-MfEjNwPkewPzf1mPUyWaFFvdOdB_8d_1v28KOTg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2432558882</pqid></control><display><type>article</type><title>Evolution of eGFR in chronic HCV patients receiving sofosbuvir-based or sofosbuvir-free direct-acting antivirals</title><source>Elsevier ScienceDirect Journals Complete</source><creator>Liu, Chen-Hua ; Lee, Mei-Hsuan ; Lin, Jou-Wei ; Liu, Chun-Jen ; Su, Tung-Hung ; Tseng, Tai-Chung ; Chen, Pei-Jer ; Chen, Ding-Shinn ; Kao, Jia-Horng</creator><creatorcontrib>Liu, Chen-Hua ; Lee, Mei-Hsuan ; Lin, Jou-Wei ; Liu, Chun-Jen ; Su, Tung-Hung ; Tseng, Tai-Chung ; Chen, Pei-Jer ; Chen, Ding-Shinn ; Kao, Jia-Horng</creatorcontrib><description>Data regarding the nephrotoxicity of sofosbuvir (SOF) remain controversial. We compared the evolution of estimated glomerular filtration rate (eGFR) in patients with chronic HCV infection receiving SOF-based or SOF-free direct-acting antivirals (DAAs).
A total of 481 patients with compensated liver diseases and eGFR ≥30 ml/min/1.73m2, receiving SOF-based (n = 308) or SOF-free (n = 173) DAAs for 12 weeks, were prospectively enrolled. The eGFR was assessed from baseline to off-treatment week 24 using the chronic kidney disease (CKD)-epidemiology collaboration equation. Differences in the evolution of eGFR between regimens were compared by a generalized linear mixed-effects model. Multivariate analysis was performed for factors affecting eGFR evolution.
Patients receiving SOF-based DAAs experienced a significant on-treatment decline in eGFR (adjusted slope coefficient difference: −1.24 ml/min/1.73m2/month; 95% CI −1.35 to −1.13; p <0.001) and a significant off-treatment improvement (adjusted slope coefficient difference: 0.14 ml/min/1.73m2/month; 95% CI 0.08 to 0.21; p = 0.004) compared to patients receiving SOF-free DAAs. Multivariate analysis showed age per 1-year increase (adjusted slope coefficient difference: −0.05 ml/min/1.73m2/month; 95% CI −0.05 to −0.04; p <0.001), SOF-based DAAs (adjusted slope coefficient difference: −0.33 ml/min/1.73m2/month; 95% CI −0.49 to −0.17; p <0.001), and CKD stage (adjusted slope coefficient difference: −1.44 ml/min/1.73m2/month; 95% CI −1.58 to −1.30; p <0.001 for stage 3 vs. 1, and −3.59 ml/min/1.73m2/month; 95% CI −3.88 to −3.30; p <0.001 for stage 2 vs. 1) were independent factors affecting eGFR evolution from baseline to off-treatment week 24.
Patients receiving SOF-based DAAs exhibited a quadratic trend, with eGFR worsening on treatment and improving off treatment. Increasing age, SOF-based DAAs, and more advanced baseline CKD stage are independently associated with a decline in eGFR in patients with HCV receiving DAAs.
While the efficacy of sofosbuvir for the treatment of hepatitis C virus is clear, data regarding its possible nephrotoxicity are controversial. Herein, we showed that sofosbuvir worsened on-treatment kidney function but led to an off-treatment improvement. Our findings suggest that treating physicians should be alert to risk factors for kidney dysfunction before initiating direct-acting antiviral treatment for patients with hepatitis C virus infection.
NCT04047680
[Display omitted]
•Patients receiving SOF-based DAAs exhibit a quadratic trend, with eGFR worsening on treatment and improving off treatment.•Patients receiving SOF-free DAAs have a linear trend with eGFR improving on and off treatment.•Increasing age, use of SOF-based DAAs, and more advanced baseline CKD stage are independent risk factors of eGFR decline.</description><identifier>ISSN: 0168-8278</identifier><identifier>EISSN: 1600-0641</identifier><identifier>DOI: 10.1016/j.jhep.2019.11.014</identifier><identifier>PMID: 31790766</identifier><language>eng</language><publisher>Netherlands: Elsevier B.V</publisher><subject>Antiviral agents ; Chronic infection ; CKD ; Direct-acting antiviral agent ; Epidemiology ; Epidermal growth factor receptors ; Estimated glomerular filtration rate ; Evolution ; Glomerular filtration rate ; Hepatitis ; Hepatitis C ; Hepatitis C virus ; Kidney diseases ; Liver diseases ; Multivariate analysis ; Renal function ; Risk factors ; Sofosbuvir ; SVR</subject><ispartof>Journal of hepatology, 2020-05, Vol.72 (5), p.839-846</ispartof><rights>2019 European Association for the Study of the Liver</rights><rights>Copyright © 2019 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.</rights><rights>Copyright Elsevier Science Ltd. May 2020</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c450t-9276b3dc54865ef59ad539557d9671508d664a63f90e0fa8af6c73f8e21b9ab3</citedby><cites>FETCH-LOGICAL-c450t-9276b3dc54865ef59ad539557d9671508d664a63f90e0fa8af6c73f8e21b9ab3</cites><orcidid>0000-0003-3622-9707 ; 0000-0002-2442-7952</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0168827819307019$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31790766$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Liu, Chen-Hua</creatorcontrib><creatorcontrib>Lee, Mei-Hsuan</creatorcontrib><creatorcontrib>Lin, Jou-Wei</creatorcontrib><creatorcontrib>Liu, Chun-Jen</creatorcontrib><creatorcontrib>Su, Tung-Hung</creatorcontrib><creatorcontrib>Tseng, Tai-Chung</creatorcontrib><creatorcontrib>Chen, Pei-Jer</creatorcontrib><creatorcontrib>Chen, Ding-Shinn</creatorcontrib><creatorcontrib>Kao, Jia-Horng</creatorcontrib><title>Evolution of eGFR in chronic HCV patients receiving sofosbuvir-based or sofosbuvir-free direct-acting antivirals</title><title>Journal of hepatology</title><addtitle>J Hepatol</addtitle><description>Data regarding the nephrotoxicity of sofosbuvir (SOF) remain controversial. We compared the evolution of estimated glomerular filtration rate (eGFR) in patients with chronic HCV infection receiving SOF-based or SOF-free direct-acting antivirals (DAAs).
A total of 481 patients with compensated liver diseases and eGFR ≥30 ml/min/1.73m2, receiving SOF-based (n = 308) or SOF-free (n = 173) DAAs for 12 weeks, were prospectively enrolled. The eGFR was assessed from baseline to off-treatment week 24 using the chronic kidney disease (CKD)-epidemiology collaboration equation. Differences in the evolution of eGFR between regimens were compared by a generalized linear mixed-effects model. Multivariate analysis was performed for factors affecting eGFR evolution.
Patients receiving SOF-based DAAs experienced a significant on-treatment decline in eGFR (adjusted slope coefficient difference: −1.24 ml/min/1.73m2/month; 95% CI −1.35 to −1.13; p <0.001) and a significant off-treatment improvement (adjusted slope coefficient difference: 0.14 ml/min/1.73m2/month; 95% CI 0.08 to 0.21; p = 0.004) compared to patients receiving SOF-free DAAs. Multivariate analysis showed age per 1-year increase (adjusted slope coefficient difference: −0.05 ml/min/1.73m2/month; 95% CI −0.05 to −0.04; p <0.001), SOF-based DAAs (adjusted slope coefficient difference: −0.33 ml/min/1.73m2/month; 95% CI −0.49 to −0.17; p <0.001), and CKD stage (adjusted slope coefficient difference: −1.44 ml/min/1.73m2/month; 95% CI −1.58 to −1.30; p <0.001 for stage 3 vs. 1, and −3.59 ml/min/1.73m2/month; 95% CI −3.88 to −3.30; p <0.001 for stage 2 vs. 1) were independent factors affecting eGFR evolution from baseline to off-treatment week 24.
Patients receiving SOF-based DAAs exhibited a quadratic trend, with eGFR worsening on treatment and improving off treatment. Increasing age, SOF-based DAAs, and more advanced baseline CKD stage are independently associated with a decline in eGFR in patients with HCV receiving DAAs.
While the efficacy of sofosbuvir for the treatment of hepatitis C virus is clear, data regarding its possible nephrotoxicity are controversial. Herein, we showed that sofosbuvir worsened on-treatment kidney function but led to an off-treatment improvement. Our findings suggest that treating physicians should be alert to risk factors for kidney dysfunction before initiating direct-acting antiviral treatment for patients with hepatitis C virus infection.
NCT04047680
[Display omitted]
•Patients receiving SOF-based DAAs exhibit a quadratic trend, with eGFR worsening on treatment and improving off treatment.•Patients receiving SOF-free DAAs have a linear trend with eGFR improving on and off treatment.•Increasing age, use of SOF-based DAAs, and more advanced baseline CKD stage are independent risk factors of eGFR decline.</description><subject>Antiviral agents</subject><subject>Chronic infection</subject><subject>CKD</subject><subject>Direct-acting antiviral agent</subject><subject>Epidemiology</subject><subject>Epidermal growth factor receptors</subject><subject>Estimated glomerular filtration rate</subject><subject>Evolution</subject><subject>Glomerular filtration rate</subject><subject>Hepatitis</subject><subject>Hepatitis C</subject><subject>Hepatitis C virus</subject><subject>Kidney diseases</subject><subject>Liver diseases</subject><subject>Multivariate analysis</subject><subject>Renal function</subject><subject>Risk factors</subject><subject>Sofosbuvir</subject><subject>SVR</subject><issn>0168-8278</issn><issn>1600-0641</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp9kNFK5TAQhsPish7dfYG9kIDXrZO2SRPwRg4eFQRBZG9Dmk7WFG1q0h7w7c3hqHjl1cDw_f8wHyF_GZQMmDgbyuERp7ICpkrGSmDND7JiAqAA0bADssqQLGTVykNylNIAADWo5hc5rFmroBViRabLbXhaZh9GGhzFq8099SO1jzGM3tLr9T86mdnjOCca0aLf-vE_TcGF1C1bH4vOJOxpiF93LiLS3md-LoyddwkzzjkazVP6TX66PPDP-zwmD5vLh_V1cXt3dbO-uC1sw2EuVNWKru4tb6Tg6LgyPa8V522vRMs4yF6IxojaKUBwRhonbFs7iRXrlOnqY3K6r51ieFkwzXoISxzzRV01dcW5lLLKVLWnbAwpRXR6iv7ZxFfNQO8c60HvHOudY82Yzo5z6OS9eumesf-MfEjNwPkewPzf1mPUyWaFFvdOdB_8d_1v28KOTg</recordid><startdate>202005</startdate><enddate>202005</enddate><creator>Liu, Chen-Hua</creator><creator>Lee, Mei-Hsuan</creator><creator>Lin, Jou-Wei</creator><creator>Liu, Chun-Jen</creator><creator>Su, Tung-Hung</creator><creator>Tseng, Tai-Chung</creator><creator>Chen, Pei-Jer</creator><creator>Chen, Ding-Shinn</creator><creator>Kao, Jia-Horng</creator><general>Elsevier B.V</general><general>Elsevier Science Ltd</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>H94</scope><orcidid>https://orcid.org/0000-0003-3622-9707</orcidid><orcidid>https://orcid.org/0000-0002-2442-7952</orcidid></search><sort><creationdate>202005</creationdate><title>Evolution of eGFR in chronic HCV patients receiving sofosbuvir-based or sofosbuvir-free direct-acting antivirals</title><author>Liu, Chen-Hua ; Lee, Mei-Hsuan ; Lin, Jou-Wei ; Liu, Chun-Jen ; Su, Tung-Hung ; Tseng, Tai-Chung ; Chen, Pei-Jer ; Chen, Ding-Shinn ; Kao, Jia-Horng</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c450t-9276b3dc54865ef59ad539557d9671508d664a63f90e0fa8af6c73f8e21b9ab3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Antiviral agents</topic><topic>Chronic infection</topic><topic>CKD</topic><topic>Direct-acting antiviral agent</topic><topic>Epidemiology</topic><topic>Epidermal growth factor receptors</topic><topic>Estimated glomerular filtration rate</topic><topic>Evolution</topic><topic>Glomerular filtration rate</topic><topic>Hepatitis</topic><topic>Hepatitis C</topic><topic>Hepatitis C virus</topic><topic>Kidney diseases</topic><topic>Liver diseases</topic><topic>Multivariate analysis</topic><topic>Renal function</topic><topic>Risk factors</topic><topic>Sofosbuvir</topic><topic>SVR</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Liu, Chen-Hua</creatorcontrib><creatorcontrib>Lee, Mei-Hsuan</creatorcontrib><creatorcontrib>Lin, Jou-Wei</creatorcontrib><creatorcontrib>Liu, Chun-Jen</creatorcontrib><creatorcontrib>Su, Tung-Hung</creatorcontrib><creatorcontrib>Tseng, Tai-Chung</creatorcontrib><creatorcontrib>Chen, Pei-Jer</creatorcontrib><creatorcontrib>Chen, Ding-Shinn</creatorcontrib><creatorcontrib>Kao, Jia-Horng</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><jtitle>Journal of hepatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Liu, Chen-Hua</au><au>Lee, Mei-Hsuan</au><au>Lin, Jou-Wei</au><au>Liu, Chun-Jen</au><au>Su, Tung-Hung</au><au>Tseng, Tai-Chung</au><au>Chen, Pei-Jer</au><au>Chen, Ding-Shinn</au><au>Kao, Jia-Horng</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Evolution of eGFR in chronic HCV patients receiving sofosbuvir-based or sofosbuvir-free direct-acting antivirals</atitle><jtitle>Journal of hepatology</jtitle><addtitle>J Hepatol</addtitle><date>2020-05</date><risdate>2020</risdate><volume>72</volume><issue>5</issue><spage>839</spage><epage>846</epage><pages>839-846</pages><issn>0168-8278</issn><eissn>1600-0641</eissn><abstract>Data regarding the nephrotoxicity of sofosbuvir (SOF) remain controversial. We compared the evolution of estimated glomerular filtration rate (eGFR) in patients with chronic HCV infection receiving SOF-based or SOF-free direct-acting antivirals (DAAs).
A total of 481 patients with compensated liver diseases and eGFR ≥30 ml/min/1.73m2, receiving SOF-based (n = 308) or SOF-free (n = 173) DAAs for 12 weeks, were prospectively enrolled. The eGFR was assessed from baseline to off-treatment week 24 using the chronic kidney disease (CKD)-epidemiology collaboration equation. Differences in the evolution of eGFR between regimens were compared by a generalized linear mixed-effects model. Multivariate analysis was performed for factors affecting eGFR evolution.
Patients receiving SOF-based DAAs experienced a significant on-treatment decline in eGFR (adjusted slope coefficient difference: −1.24 ml/min/1.73m2/month; 95% CI −1.35 to −1.13; p <0.001) and a significant off-treatment improvement (adjusted slope coefficient difference: 0.14 ml/min/1.73m2/month; 95% CI 0.08 to 0.21; p = 0.004) compared to patients receiving SOF-free DAAs. Multivariate analysis showed age per 1-year increase (adjusted slope coefficient difference: −0.05 ml/min/1.73m2/month; 95% CI −0.05 to −0.04; p <0.001), SOF-based DAAs (adjusted slope coefficient difference: −0.33 ml/min/1.73m2/month; 95% CI −0.49 to −0.17; p <0.001), and CKD stage (adjusted slope coefficient difference: −1.44 ml/min/1.73m2/month; 95% CI −1.58 to −1.30; p <0.001 for stage 3 vs. 1, and −3.59 ml/min/1.73m2/month; 95% CI −3.88 to −3.30; p <0.001 for stage 2 vs. 1) were independent factors affecting eGFR evolution from baseline to off-treatment week 24.
Patients receiving SOF-based DAAs exhibited a quadratic trend, with eGFR worsening on treatment and improving off treatment. Increasing age, SOF-based DAAs, and more advanced baseline CKD stage are independently associated with a decline in eGFR in patients with HCV receiving DAAs.
While the efficacy of sofosbuvir for the treatment of hepatitis C virus is clear, data regarding its possible nephrotoxicity are controversial. Herein, we showed that sofosbuvir worsened on-treatment kidney function but led to an off-treatment improvement. Our findings suggest that treating physicians should be alert to risk factors for kidney dysfunction before initiating direct-acting antiviral treatment for patients with hepatitis C virus infection.
NCT04047680
[Display omitted]
•Patients receiving SOF-based DAAs exhibit a quadratic trend, with eGFR worsening on treatment and improving off treatment.•Patients receiving SOF-free DAAs have a linear trend with eGFR improving on and off treatment.•Increasing age, use of SOF-based DAAs, and more advanced baseline CKD stage are independent risk factors of eGFR decline.</abstract><cop>Netherlands</cop><pub>Elsevier B.V</pub><pmid>31790766</pmid><doi>10.1016/j.jhep.2019.11.014</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0003-3622-9707</orcidid><orcidid>https://orcid.org/0000-0002-2442-7952</orcidid></addata></record> |
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| source | Elsevier ScienceDirect Journals Complete |
| subjects | Antiviral agents Chronic infection CKD Direct-acting antiviral agent Epidemiology Epidermal growth factor receptors Estimated glomerular filtration rate Evolution Glomerular filtration rate Hepatitis Hepatitis C Hepatitis C virus Kidney diseases Liver diseases Multivariate analysis Renal function Risk factors Sofosbuvir SVR |
| title | Evolution of eGFR in chronic HCV patients receiving sofosbuvir-based or sofosbuvir-free direct-acting antivirals |
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