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A real-world intention-to-treat analysis of a decade’s experience of treatment of hepatitis C with interferon-based therapies

Objectives: To assess the uptake of pegylated interferon (PegIFN) plus ribavirin (RBV)-based regimens in patients with hepatitis C virus (HCV) in a large, single-centre, real-world setting over 10 years. Methods: This was a single centre, retrospective analysis of data from patients who attended the...

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Autores principales: Selvapatt, Nowlan, Brown, Ashley
Formato: Online Artículo Texto
Lenguaje:English
Publicado: F1000Research 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5034792/
https://www.ncbi.nlm.nih.gov/pubmed/27746906
http://dx.doi.org/10.12688/f1000research.9114.1
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author Selvapatt, Nowlan
Brown, Ashley
author_facet Selvapatt, Nowlan
Brown, Ashley
author_sort Selvapatt, Nowlan
collection PubMed
description Objectives: To assess the uptake of pegylated interferon (PegIFN) plus ribavirin (RBV)-based regimens in patients with hepatitis C virus (HCV) in a large, single-centre, real-world setting over 10 years. Methods: This was a single centre, retrospective analysis of data from patients who attended their first appointment for treatment of HCV genotype 1–3 between 2003 and 2013. Patients were stratified by HCV genotype. The total number of patients who attended their first appointment, incidence of patients who did not proceed to treatment and associated reasons, and incidence of patients treated were analysed. Sustained virological response (SVR) rates were also reported for all patient populations. Results: Overall, 1,132 patients attended their first appointment; 47.8% were included in the genotype 1 group (genotype 1a: 22.2%, genotype 1b: 13.3%, genotype 1 other: 12.3%), 7.7% in the genotype 2 group and 44.5% in the genotype 3 group. A greater proportion of patients received treatment versus those who did not receive treatment (84.4% vs 15.6%, respectively). Reasons for declining treatment included: patient declined treatment with PegIFN plus RBV: 35.0%, medical contraindications: 20.3% and mental health-related contraindications: 13.6%. An SVR was achieved in 52.6% of patients who attended their first appointment and 62.3% of patients who received treatment. Conclusions: Approximately half of the patients included in this study achieved an SVR. A noteworthy proportion of patients did not receive treatment due to a reluctance to receive PegIFN plus RBV or contraindications to therapy. Results suggest an ongoing need for improvement in the treatment uptake and overall outcomes – particularly for genotype 2 and 3 patients for whom availability of interferon-free regimens is limited. The introduction of more tolerable direct-acting antiviral regimes may help overcome barriers to uptake demonstrated within this cohort.
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spelling pubmed-50347922016-10-13 A real-world intention-to-treat analysis of a decade’s experience of treatment of hepatitis C with interferon-based therapies Selvapatt, Nowlan Brown, Ashley F1000Res Research Article Objectives: To assess the uptake of pegylated interferon (PegIFN) plus ribavirin (RBV)-based regimens in patients with hepatitis C virus (HCV) in a large, single-centre, real-world setting over 10 years. Methods: This was a single centre, retrospective analysis of data from patients who attended their first appointment for treatment of HCV genotype 1–3 between 2003 and 2013. Patients were stratified by HCV genotype. The total number of patients who attended their first appointment, incidence of patients who did not proceed to treatment and associated reasons, and incidence of patients treated were analysed. Sustained virological response (SVR) rates were also reported for all patient populations. Results: Overall, 1,132 patients attended their first appointment; 47.8% were included in the genotype 1 group (genotype 1a: 22.2%, genotype 1b: 13.3%, genotype 1 other: 12.3%), 7.7% in the genotype 2 group and 44.5% in the genotype 3 group. A greater proportion of patients received treatment versus those who did not receive treatment (84.4% vs 15.6%, respectively). Reasons for declining treatment included: patient declined treatment with PegIFN plus RBV: 35.0%, medical contraindications: 20.3% and mental health-related contraindications: 13.6%. An SVR was achieved in 52.6% of patients who attended their first appointment and 62.3% of patients who received treatment. Conclusions: Approximately half of the patients included in this study achieved an SVR. A noteworthy proportion of patients did not receive treatment due to a reluctance to receive PegIFN plus RBV or contraindications to therapy. Results suggest an ongoing need for improvement in the treatment uptake and overall outcomes – particularly for genotype 2 and 3 patients for whom availability of interferon-free regimens is limited. The introduction of more tolerable direct-acting antiviral regimes may help overcome barriers to uptake demonstrated within this cohort. F1000Research 2016-08-24 /pmc/articles/PMC5034792/ /pubmed/27746906 http://dx.doi.org/10.12688/f1000research.9114.1 Text en Copyright: © 2016 Selvapatt N and Brown A http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Selvapatt, Nowlan
Brown, Ashley
A real-world intention-to-treat analysis of a decade’s experience of treatment of hepatitis C with interferon-based therapies
title A real-world intention-to-treat analysis of a decade’s experience of treatment of hepatitis C with interferon-based therapies
title_full A real-world intention-to-treat analysis of a decade’s experience of treatment of hepatitis C with interferon-based therapies
title_fullStr A real-world intention-to-treat analysis of a decade’s experience of treatment of hepatitis C with interferon-based therapies
title_full_unstemmed A real-world intention-to-treat analysis of a decade’s experience of treatment of hepatitis C with interferon-based therapies
title_short A real-world intention-to-treat analysis of a decade’s experience of treatment of hepatitis C with interferon-based therapies
title_sort real-world intention-to-treat analysis of a decade’s experience of treatment of hepatitis c with interferon-based therapies
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5034792/
https://www.ncbi.nlm.nih.gov/pubmed/27746906
http://dx.doi.org/10.12688/f1000research.9114.1
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