Ombitasvir/paritaprevir/r, dasabuvir and ribavirin for cirrhotic HCV patients with thrombocytopaenia and hypoalbuminaemia

Fecha de publicación: 01/11/2015

Autores de IIS La Fe

María Del Valle Pedrosa Del Moral

Autor
Marina Berenguer Haym

Autor

Participantes ajenos a IIS La Fe

Forns X
Poordad F
Wedemeyer H
Ferenci P
Shiffman ML
Fried MW
Lovell S
Trinh R
Lopez-Talavera JC
Everson G

Grupos

Hepatología, Cirugia Hepatobiliopancreática y Trasplantes

Leader

Marina Berenguer Haym

Abstract

Background & AimsThrombocytopaenia and hypoalbuminaemia are surrogate markers for portal hypertension and hepatic synthetic dysfunction respectively. Patients infected with hepatitis C virus (HCV) with these surrogates have reduced likelihood of sustained virologic response and increased risk for hepatic decompensation or death when treated with peginterferon/ribavirin plus either telaprevir or boceprevir. MethodsWe conducted a post-hoc analysis of the TURQUOISE-II clinical trial in patients with cirrhosis to examine the impact of these surrogates on efficacy and safety of ombitasvir/paritaprevir/ritonavir and dasabuvir with ribavirin. ResultsOf 380 genotype 1-infected patients in TURQUOISE-II, 104 had either a platelet count <100x10(9)/L or albumin <3.5g/dl. Sustained virologic response rates were 89 and 97% in patients with thrombocytopaenia, and 84 and 89% in patients with hypoalbuminaemia after 12 and 24weeks of ombitasvir/paritaprevir/ritonavir and dasabuvir with ribavirin respectively. These rates were similar to those observed in the overall study population (92 and 97% for 12 and 24weeks). HCV genotype 1a-infected patients with thrombocytopaenia or hypoalbuminaemia had higher response rates when treated for 24weeks, whereas only 1 of 35 genotype 1b patients did not achieve a sustained virologic response. Adverse event rates and discontinuations because of adverse events were low. ConclusionsThe findings of these analyses support the use of ombitasvir/paritaprevir/ritonavir and dasabuvir with ribavirin in these subpopulations with cirrhosis. Genotype 1a-infected patients with indicators of portal hypertension may benefit from a 24-week treatment duration.

Datos de la publicación

ISSN/ISSNe:: 1478-3223, 1478-3231
Tipo:: Article
Páginas:: 2358-2362
DOI:: 10.1111/liv.12931
Factor de Impacto:: 1,710 SCImago ℠
Cuartil:: Q1 SCImago ℠

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Filiaciones

Forns X:: Liver Unit, Hospital Clinic, CIBERehd, IDIBAPS, Barcelona, Spain
Poordad F:: The Texas Liver Institute/University of Texas Health Science Center, San Antonio, TX, USA
Pedrosa M:: AbbVie Inc., North Chicago, IL, USA
Berenguer M:: La Fe University Hospital and CIBERehd, Valencia, Spain
Wedemeyer H:: Hannover Medical School, Hannover, Germany
Ferenci P:: Medical University of Vienna, Vienna, Austria
Shiffman ML:: Liver Institute of Virginia, Bon Secours Health System, Newport News, VA, USA

Liver Institute of Virginia, Bon Secours Health System, Richmond, VA, USA
Fried MW:: University of North Carolina at Chapel Hill, UNC Liver Center, Chapel Hill, NC, USA
Lovell S:: AbbVie Inc., North Chicago, IL, USA
Trinh R:: AbbVie Inc., North Chicago, IL, USA
Lopez-Talavera JC:: AbbVie Inc., North Chicago, IL, USA
Everson G:: University of Colorado Denver School of Medicine, Aurora, CO, USA