Liver Int:接受DAA与利巴韦林联合治疗的HCV患者,利巴韦林剂量的调整并不影响治疗效果

2018-02-02 MedSci MedSci原创

DAA联合利巴韦林治疗的HCV患者,在治疗早期经常将利巴韦林的剂量降低;利巴韦林剂量的降低并没有影响可持续病毒学应答率。基线血红蛋白水平较低的HCV患者,在治疗过程中应该检测是否发生贫血

一些接受直接抗病毒药物(DAA)治疗的HCV患者,需要利巴韦林来获得最大化的持续的病毒学反应速率。本研究在接受ombitasvir/paritaprevir/ritonavir和dasabuvir联合利巴韦林治疗的HCV患者中,描述利巴韦林剂量剂量管理相关问题。

本研究采用事后分析方法对接受ombitasvir/paritaprevir/ritonavir 和dasabuvir联合利巴韦林治疗12周或24周的6个3期临床试验的HCV患者进行了分析。多元逐步logistic回归模型评估与利巴韦林剂量调整和发生贫血相关的预测因子。

在1548例HCV患者中,在治疗后的12周内,6.5%(100例患者)的患者因血红蛋白下降而改变了利巴韦林的剂量,其中99%的HCV患者获得了持续的病毒学反应。首次利巴韦林剂量减少的中位时间为37天。基线低血红蛋白水平与治疗过程中利巴韦林剂量的调整(优势比:0.618 [0.518, 0.738]; P < .001)和贫血的发生显著相关(优势比:0.379 [0.243, 0.593]; P < .001)。

DAA联合利巴韦林治疗的HCV患者,在治疗早期经常将利巴韦林的剂量降低;利巴韦林剂量的降低并没有影响可持续病毒学应答率。基线血红蛋白水平较低的HCV患者,在治疗过程中应该检测是否发生贫血。

原始出处

Feld JJ, Bernstein DE, Younes Z, et al. Ribavirin Dose Management in HCV Patients Receiving Ombitasvir/Paritaprevir/Ritonavir and Dasabuvir with Ribavirin. Liver Int, 2018, Jan 27. doi: 10.1111/liv.13708.

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    2018-02-04 ymljack
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    2018-02-04 qingting

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