TY - JOUR
T1 - The elderly and direct antiviral agents
T2 - Constraint or challenge?
AU - Fabrizio, Claudia
AU - Saracino, Annalisa
AU - Scudeller, Luigia
AU - Milano, Eugenio
AU - Dell'Acqua, Raffaele
AU - Bruno, Giuseppe
AU - Lo Caputo, Sergio
AU - Monno, Laura
AU - Milella, Michele
AU - Angarano, Gioacchino
PY - 2017/9/1
Y1 - 2017/9/1
N2 - Background Direct antiviral agents (DAAs) for chronic hepatitis C showed great effectiveness and good safety profile. So far, few data are available about their use in elderly subjects. Aim To assess management, safety and outcome of DAAs treatments in the elderly. Methods This retrospective, single-centre study enrolled all patients aged ≥65 years, compared by age (group A: 65–74 years, group B: ≥75 years), who completed DAAs between February 2015–November 2016. Variables potentially associated to adverse events (AEs) were analyzed. Sustained virological response (SVR) was evaluated at 12-weeks follow-up. Results DAAs were administered to 221 patients aged ≥65 years (males: 112; group A: 130, group B: 91). Prescribed regimens were: sofosbuvir-based: 44 patients (19.9%), simeprevir-based: 25 (15%), ledipasvir-based: 49 (22.2%), daclatasvir-based: 12 (5.4%), paritaprevir/ritonavir + ombitasvir ± dasabuvir: 91 (41.2%). Ribavirin was used in 121 patients. In 58 subjects co-medications were adjusted due to drug interactions. At least one AE occurred in 130 patients, including 13 SAEs, mainly in older subjects (p = 0.04). Female sex (p = 0.04), liver stiffness (p = 0.023), use of simeprevir (p = 0.03) and ribavirin (p = 0.009) were associated with AEs. SVR-12 was achieved in 96,9% of subjects. Conclusions A careful baseline evaluation and a strict monitoring allow to optimise management and outcome of DAAs in elderly.
AB - Background Direct antiviral agents (DAAs) for chronic hepatitis C showed great effectiveness and good safety profile. So far, few data are available about their use in elderly subjects. Aim To assess management, safety and outcome of DAAs treatments in the elderly. Methods This retrospective, single-centre study enrolled all patients aged ≥65 years, compared by age (group A: 65–74 years, group B: ≥75 years), who completed DAAs between February 2015–November 2016. Variables potentially associated to adverse events (AEs) were analyzed. Sustained virological response (SVR) was evaluated at 12-weeks follow-up. Results DAAs were administered to 221 patients aged ≥65 years (males: 112; group A: 130, group B: 91). Prescribed regimens were: sofosbuvir-based: 44 patients (19.9%), simeprevir-based: 25 (15%), ledipasvir-based: 49 (22.2%), daclatasvir-based: 12 (5.4%), paritaprevir/ritonavir + ombitasvir ± dasabuvir: 91 (41.2%). Ribavirin was used in 121 patients. In 58 subjects co-medications were adjusted due to drug interactions. At least one AE occurred in 130 patients, including 13 SAEs, mainly in older subjects (p = 0.04). Female sex (p = 0.04), liver stiffness (p = 0.023), use of simeprevir (p = 0.03) and ribavirin (p = 0.009) were associated with AEs. SVR-12 was achieved in 96,9% of subjects. Conclusions A careful baseline evaluation and a strict monitoring allow to optimise management and outcome of DAAs in elderly.
KW - Antiviral treatment
KW - Chronic hepatitis C
KW - HCV
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U2 - 10.1016/j.dld.2017.05.019
DO - 10.1016/j.dld.2017.05.019
M3 - Article
AN - SCOPUS:85021196723
VL - 49
SP - 1036
EP - 1042
JO - Digestive and Liver Disease
JF - Digestive and Liver Disease
SN - 1590-8658
IS - 9
ER -