Sustained Virological Response After Early Discontinuation of Hepatitis C Treatment
ABSTRACT To date, the effectiveness of direct‐acting antivirals (DAAs) discontinued before 4 weeks has not been analysed in routine clinical practice. The study aimed to determine whether such a short therapy will enable achieving a sustained virological response under real‐world experience. The stu...
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Veröffentlicht in: | Journal of viral hepatitis 2024-11, Vol.31 (11), p.677-685 |
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creator | Flisiak, Robert Zarębska‐Michaluk, Dorota Janczewska, Ewa Parfieniuk‐Kowerda, Anna Mazur, Włodzimierz Sitko, Marek Janocha‐Litwin, Justyna Krygier, Rafał Lorenc, Beata Piekarska, Anna Sobala‐Szczygieł, Barbara Dobrowolska, Krystyna Socha, Łukasz Jaroszewicz, Jerzy |
description | ABSTRACT
To date, the effectiveness of direct‐acting antivirals (DAAs) discontinued before 4 weeks has not been analysed in routine clinical practice. The study aimed to determine whether such a short therapy will enable achieving a sustained virological response under real‐world experience. The study population of 97 patients who discontinued DAA therapy and had data enabling analysis of patient and disease characteristics, and assessment of treatment effectiveness was selected from 16,815 patients registered in the EpiTer‐2 database. The most common reason for discontinuation was hepatic decompensation (20.6%) or the patient's personal decision (18.6%). Patients who discontinued treatment were significantly older, more frequently therapy‐experienced, more likely to have cirrhosis, a history of decompensation and a Child–Pugh B or C classification than those who completed treatment. SVR was achieved by 93.5% of patients who discontinued treatment after 4 weeks, 60.9% if discontinued at 3 or 4 week and 33.3% at Week 1 or 2. Patients receiving pangenotypic but not genotype‐specific treatment who discontinued after 4 weeks were as likely to achieve SVR as those who completed therapy. Patients who responded to treatment that lasted no longer than 2 weeks had a low baseline viral load ( |
doi_str_mv | 10.1111/jvh.13991 |
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To date, the effectiveness of direct‐acting antivirals (DAAs) discontinued before 4 weeks has not been analysed in routine clinical practice. The study aimed to determine whether such a short therapy will enable achieving a sustained virological response under real‐world experience. The study population of 97 patients who discontinued DAA therapy and had data enabling analysis of patient and disease characteristics, and assessment of treatment effectiveness was selected from 16,815 patients registered in the EpiTer‐2 database. The most common reason for discontinuation was hepatic decompensation (20.6%) or the patient's personal decision (18.6%). Patients who discontinued treatment were significantly older, more frequently therapy‐experienced, more likely to have cirrhosis, a history of decompensation and a Child–Pugh B or C classification than those who completed treatment. SVR was achieved by 93.5% of patients who discontinued treatment after 4 weeks, 60.9% if discontinued at 3 or 4 week and 33.3% at Week 1 or 2. Patients receiving pangenotypic but not genotype‐specific treatment who discontinued after 4 weeks were as likely to achieve SVR as those who completed therapy. Patients who responded to treatment that lasted no longer than 2 weeks had a low baseline viral load (<400,000 IU/mL). Despite discontinuation of therapy after Week 4, the chances of SVR are high. Very early discontinuation does not preclude therapeutic success, especially in patients with low baseline viral load.</description><identifier>ISSN: 1352-0504</identifier><identifier>ISSN: 1365-2893</identifier><identifier>EISSN: 1365-2893</identifier><identifier>DOI: 10.1111/jvh.13991</identifier><identifier>PMID: 39109641</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Antiviral agents ; Cirrhosis ; direct‐acting antivirals ; discontinuation ; Genotypes ; HCV ; Hepatitis C ; Patients ; Population studies ; sustained virologic response ; treatment</subject><ispartof>Journal of viral hepatitis, 2024-11, Vol.31 (11), p.677-685</ispartof><rights>2024 John Wiley & Sons Ltd.</rights><rights>Copyright © 2024 John Wiley & Sons Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c2431-a93481f7fe7bedf7c9dc218da4b8c6c3f6fc2d9970d8059230044dc2f5a817d3</cites><orcidid>0000-0002-3815-3745 ; 0000-0002-5406-4603 ; 0000-0003-0352-9893 ; 0000-0003-0938-1084</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjvh.13991$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjvh.13991$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27903,27904,45553,45554</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39109641$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Flisiak, Robert</creatorcontrib><creatorcontrib>Zarębska‐Michaluk, Dorota</creatorcontrib><creatorcontrib>Janczewska, Ewa</creatorcontrib><creatorcontrib>Parfieniuk‐Kowerda, Anna</creatorcontrib><creatorcontrib>Mazur, Włodzimierz</creatorcontrib><creatorcontrib>Sitko, Marek</creatorcontrib><creatorcontrib>Janocha‐Litwin, Justyna</creatorcontrib><creatorcontrib>Krygier, Rafał</creatorcontrib><creatorcontrib>Lorenc, Beata</creatorcontrib><creatorcontrib>Piekarska, Anna</creatorcontrib><creatorcontrib>Sobala‐Szczygieł, Barbara</creatorcontrib><creatorcontrib>Dobrowolska, Krystyna</creatorcontrib><creatorcontrib>Socha, Łukasz</creatorcontrib><creatorcontrib>Jaroszewicz, Jerzy</creatorcontrib><title>Sustained Virological Response After Early Discontinuation of Hepatitis C Treatment</title><title>Journal of viral hepatitis</title><addtitle>J Viral Hepat</addtitle><description>ABSTRACT
To date, the effectiveness of direct‐acting antivirals (DAAs) discontinued before 4 weeks has not been analysed in routine clinical practice. The study aimed to determine whether such a short therapy will enable achieving a sustained virological response under real‐world experience. The study population of 97 patients who discontinued DAA therapy and had data enabling analysis of patient and disease characteristics, and assessment of treatment effectiveness was selected from 16,815 patients registered in the EpiTer‐2 database. The most common reason for discontinuation was hepatic decompensation (20.6%) or the patient's personal decision (18.6%). Patients who discontinued treatment were significantly older, more frequently therapy‐experienced, more likely to have cirrhosis, a history of decompensation and a Child–Pugh B or C classification than those who completed treatment. SVR was achieved by 93.5% of patients who discontinued treatment after 4 weeks, 60.9% if discontinued at 3 or 4 week and 33.3% at Week 1 or 2. Patients receiving pangenotypic but not genotype‐specific treatment who discontinued after 4 weeks were as likely to achieve SVR as those who completed therapy. Patients who responded to treatment that lasted no longer than 2 weeks had a low baseline viral load (<400,000 IU/mL). Despite discontinuation of therapy after Week 4, the chances of SVR are high. Very early discontinuation does not preclude therapeutic success, especially in patients with low baseline viral load.</description><subject>Antiviral agents</subject><subject>Cirrhosis</subject><subject>direct‐acting antivirals</subject><subject>discontinuation</subject><subject>Genotypes</subject><subject>HCV</subject><subject>Hepatitis C</subject><subject>Patients</subject><subject>Population studies</subject><subject>sustained virologic response</subject><subject>treatment</subject><issn>1352-0504</issn><issn>1365-2893</issn><issn>1365-2893</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp10E1LAzEQBuAgitaPg39AAl70sDWT7HaTo9RqlYKgxWtIs4mmbDc12VX6701t9SA4l5nDw8vwInQKpA9pruYfb31gQsAO6gEbFBnlgu2u74JmpCD5ATqMcU4IMFrAPjpgAogY5NBDz89dbJVrTIVfXPC1f3Va1fjJxKVvosHXtjUBj1SoV_jGRe2b1jWdap1vsLd4bJbpbl3EQzwNRrUL07THaM-qOpqT7T5C09vRdDjOJo9398PrSaZpziBTguUcbGlNOTOVLbWoNAVeqXzG9UAzO7CaVkKUpOKkEJQRkueJ2EJxKCt2hC42scvg3zsTW7lID5q6Vo3xXZSMcME5ZRwSPf9D574LTXpOMoDESprTpC43SgcfYzBWLoNbqLCSQOS6aJmKlt9FJ3u2TexmC1P9yp9mE7jagE9Xm9X_SfLhZbyJ_AKtxoc8</recordid><startdate>202411</startdate><enddate>202411</enddate><creator>Flisiak, Robert</creator><creator>Zarębska‐Michaluk, Dorota</creator><creator>Janczewska, Ewa</creator><creator>Parfieniuk‐Kowerda, Anna</creator><creator>Mazur, Włodzimierz</creator><creator>Sitko, Marek</creator><creator>Janocha‐Litwin, Justyna</creator><creator>Krygier, Rafał</creator><creator>Lorenc, Beata</creator><creator>Piekarska, Anna</creator><creator>Sobala‐Szczygieł, Barbara</creator><creator>Dobrowolska, Krystyna</creator><creator>Socha, Łukasz</creator><creator>Jaroszewicz, Jerzy</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-3815-3745</orcidid><orcidid>https://orcid.org/0000-0002-5406-4603</orcidid><orcidid>https://orcid.org/0000-0003-0352-9893</orcidid><orcidid>https://orcid.org/0000-0003-0938-1084</orcidid></search><sort><creationdate>202411</creationdate><title>Sustained Virological Response After Early Discontinuation of Hepatitis C Treatment</title><author>Flisiak, Robert ; Zarębska‐Michaluk, Dorota ; Janczewska, Ewa ; Parfieniuk‐Kowerda, Anna ; Mazur, Włodzimierz ; Sitko, Marek ; Janocha‐Litwin, Justyna ; Krygier, Rafał ; Lorenc, Beata ; Piekarska, Anna ; Sobala‐Szczygieł, Barbara ; Dobrowolska, Krystyna ; Socha, Łukasz ; Jaroszewicz, Jerzy</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c2431-a93481f7fe7bedf7c9dc218da4b8c6c3f6fc2d9970d8059230044dc2f5a817d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Antiviral agents</topic><topic>Cirrhosis</topic><topic>direct‐acting antivirals</topic><topic>discontinuation</topic><topic>Genotypes</topic><topic>HCV</topic><topic>Hepatitis C</topic><topic>Patients</topic><topic>Population studies</topic><topic>sustained virologic response</topic><topic>treatment</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Flisiak, Robert</creatorcontrib><creatorcontrib>Zarębska‐Michaluk, Dorota</creatorcontrib><creatorcontrib>Janczewska, Ewa</creatorcontrib><creatorcontrib>Parfieniuk‐Kowerda, Anna</creatorcontrib><creatorcontrib>Mazur, Włodzimierz</creatorcontrib><creatorcontrib>Sitko, Marek</creatorcontrib><creatorcontrib>Janocha‐Litwin, Justyna</creatorcontrib><creatorcontrib>Krygier, Rafał</creatorcontrib><creatorcontrib>Lorenc, Beata</creatorcontrib><creatorcontrib>Piekarska, Anna</creatorcontrib><creatorcontrib>Sobala‐Szczygieł, Barbara</creatorcontrib><creatorcontrib>Dobrowolska, Krystyna</creatorcontrib><creatorcontrib>Socha, Łukasz</creatorcontrib><creatorcontrib>Jaroszewicz, Jerzy</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of viral hepatitis</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Flisiak, Robert</au><au>Zarębska‐Michaluk, Dorota</au><au>Janczewska, Ewa</au><au>Parfieniuk‐Kowerda, Anna</au><au>Mazur, Włodzimierz</au><au>Sitko, Marek</au><au>Janocha‐Litwin, Justyna</au><au>Krygier, Rafał</au><au>Lorenc, Beata</au><au>Piekarska, Anna</au><au>Sobala‐Szczygieł, Barbara</au><au>Dobrowolska, Krystyna</au><au>Socha, Łukasz</au><au>Jaroszewicz, Jerzy</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Sustained Virological Response After Early Discontinuation of Hepatitis C Treatment</atitle><jtitle>Journal of viral hepatitis</jtitle><addtitle>J Viral Hepat</addtitle><date>2024-11</date><risdate>2024</risdate><volume>31</volume><issue>11</issue><spage>677</spage><epage>685</epage><pages>677-685</pages><issn>1352-0504</issn><issn>1365-2893</issn><eissn>1365-2893</eissn><abstract>ABSTRACT
To date, the effectiveness of direct‐acting antivirals (DAAs) discontinued before 4 weeks has not been analysed in routine clinical practice. The study aimed to determine whether such a short therapy will enable achieving a sustained virological response under real‐world experience. The study population of 97 patients who discontinued DAA therapy and had data enabling analysis of patient and disease characteristics, and assessment of treatment effectiveness was selected from 16,815 patients registered in the EpiTer‐2 database. The most common reason for discontinuation was hepatic decompensation (20.6%) or the patient's personal decision (18.6%). Patients who discontinued treatment were significantly older, more frequently therapy‐experienced, more likely to have cirrhosis, a history of decompensation and a Child–Pugh B or C classification than those who completed treatment. SVR was achieved by 93.5% of patients who discontinued treatment after 4 weeks, 60.9% if discontinued at 3 or 4 week and 33.3% at Week 1 or 2. Patients receiving pangenotypic but not genotype‐specific treatment who discontinued after 4 weeks were as likely to achieve SVR as those who completed therapy. Patients who responded to treatment that lasted no longer than 2 weeks had a low baseline viral load (<400,000 IU/mL). Despite discontinuation of therapy after Week 4, the chances of SVR are high. Very early discontinuation does not preclude therapeutic success, especially in patients with low baseline viral load.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>39109641</pmid><doi>10.1111/jvh.13991</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-3815-3745</orcidid><orcidid>https://orcid.org/0000-0002-5406-4603</orcidid><orcidid>https://orcid.org/0000-0003-0352-9893</orcidid><orcidid>https://orcid.org/0000-0003-0938-1084</orcidid></addata></record> |
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subjects | Antiviral agents Cirrhosis direct‐acting antivirals discontinuation Genotypes HCV Hepatitis C Patients Population studies sustained virologic response treatment |
title | Sustained Virological Response After Early Discontinuation of Hepatitis C Treatment |
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