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Acta Med Port ; 37(5): 323-333, 2024 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-38325411

RESUMO

INTRODUCTION: Information about pan-genotypic treatments for hepatitis in Portugal is scarce. We aimed to evaluate the effectiveness and safety of glecaprevir plus pibrentasvir (GLE/PIB) treatment for hepatitis C virus (HCV) infection in real-world clinical practice. METHODS: An observational prospective study was implemented in six hospitals with 121 adult HCV patients who initiated treatment with GLE/PIB between October 2018 and April 2019, according to clinical practice. Eligible patients had confirmed HCV infection genotype (GT) 1 to 6 and were either treatment-naïve or had experience with interferon-, ribavirin- or sofosbuvir-based regimens, with or without compensated cirrhosis. Baseline sociodemographic and safety data are described for the total population (N = 115). Effectiveness [sustained virologic response 12 weeks after treatment (SVR12)] and patient-reported outcomes are presented for the core population with sufficient follow-up data (n = 97). RESULTS: Most patients were male (83.5%), aged < 65 years (94.8%), with current or former alcohol consumption (77.3%), illicit drug use (72.6%), and HCV acquisition through intravenous drug use (62.0%). HIV co-infection occurred in 22.6% of patients. The prevalence of each GT was: GT1 51.3%, GT2 1.7%, GT3 30.4%, GT4 16.5%, and GT5.6 0%. Most patients were non-cirrhotic (80.9%) and treatment-naïve (93.8%). The SVR12 rates were 97.9% (95% CI: 92.8 - 99.4), and > 95% across cirrhosis status, GT, illicit drug use, alcohol consumption, and HCV treatment experience. The adverse event rate was 2.6%, and no patient discontinued treatment due to adverse events related to GLE/PIB. CONCLUSION: Consistent with other real-world studies and clinical trials, treatment with GLE/PIB showed high effectiveness and tolerability overall and in difficult-to-treat subgroups (ClinicalTrials.gov: NCT03303599).


Assuntos
Antivirais , Benzimidazóis , Combinação de Medicamentos , Hepatite C Crônica , Pirrolidinas , Quinoxalinas , Sulfonamidas , Humanos , Masculino , Feminino , Benzimidazóis/uso terapêutico , Benzimidazóis/efeitos adversos , Hepatite C Crônica/tratamento farmacológico , Pessoa de Meia-Idade , Estudos Prospectivos , Quinoxalinas/uso terapêutico , Quinoxalinas/efeitos adversos , Antivirais/uso terapêutico , Antivirais/efeitos adversos , Sulfonamidas/uso terapêutico , Sulfonamidas/efeitos adversos , Pirrolidinas/efeitos adversos , Pirrolidinas/uso terapêutico , Idoso , Portugal , Resposta Viral Sustentada , Resultado do Tratamento , Adulto , Leucina/análogos & derivados , Leucina/uso terapêutico , Hepacivirus/genética , Lactamas Macrocíclicas , Ácidos Aminoisobutíricos
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