Category: Professional Posters
Purpose: Sofosbuvir/ledipasvir, elbasvir/grezoprevir and glecaprevir/pibrentasvir,
a direct-acting antiviral agents (DAAs), are recommended as the first-line treatment for hepatitis C virus (HCV) infection in Taiwan. These agents achieve high and sustained virological response (SVR) rates in clinical trials. However, head-to-head comparison between these three antiviral agents in the real-world clinical practice remains unclear. To fill the gap, this study aims to evaluate the effectiveness and analyze prescription patterns of DAAs.
Methods: This was a retrospective cohort study by using the electronic medical records databases from 3 hospitals in northern Taiwan (8% of the population in this region). We enrolled the patients who newly started antiviral therapy between January 1, 2018 and October 31, 2018. The antiviral agents of study interest included sofosbuvir/ledipasvir, elbasvir/grezoprevir and glecaprevir/pibrentasvir. We followed these patients from the initiations of DAAs to May 31, 2019 or loss of follow-up.
The primary endpoint was sustained virological response at 12 weeks after therapy (SVR12). The secondary endpoint was rapid virological response (RVR) rates, which defined as no HCV RNA detection at fourth week after therapy. We also collected patients’ characteristics included：sex, age, genotype, viral load, AST, ALT, estimated glomerular filtration rate (eGFR), liver cirrhosis, hepatitis B, combination of ribavirin. Descriptive statistics were used to characterize the information collected.
Results: We enrolled a total of 71 (34.6%) sofosbuvir/ledipasvir users, 59 (28.8%) elbasvir/grezoprevir users and 75 (36.6%) glecaprevir/pibrentasvir users with 64.7 years old (SD 12.1), of whom 38.5% were men. Before initiation of DAAs, the mean HCV RNA was 3.4 (SD 6.2) million IU/ml at baseline.
198 (96.6%) patients achieved SVR12 and 7 failed (4 were on sofosbuvir/ledipasvir, 1 was on elbasvir/grezoprevir and 2 were on glecaprevir/pibrentasvir). 118 (57.6%) patients achieved RVR (52.1% were on sofosbuvir/ledipasvir, 52.5% were on elbasvir/grezoprevir and 66.7% were on glecaprevir/pibrentasvir).
Conclusion: Patients accepted these three antiviral agents had similar SVR12 rate. Patients with glecaprevir/pibrentasvir had a little higher RVR rate than other groups. Clinicians should consider patients’ baseline profiles, like renal function, liver function and bill burden, when selecting DAA.