In:
Liver International, Wiley, Vol. 34, No. 7 ( 2014-08), p. 1018-1024
Abstract:
Adding telaprevir to pegylated‐interferon and ribavirin increased both response rates and side effects of hepatitis C virus ( HCV ) treatment. We identified variables associated with severe anaemia during telaprevir‐based triple therapy. Methods An observational study was performed on 142 HCV‐infected patients between June 2011 and March 2012. All subjects completed 12 weeks of telaprevir‐based triple therapy or discontinued early because of anaemia. Severe anaemia was defined by a haemoglobin ≤8.9 g/dl; advanced fibrosis was determined by Fib‐4 ≥3.25. Results The 47 (33%) patients who developed severe anaemia were similar to those who did not in sex, race, and prior response to dual therapy, but they were more likely to have diabetes (23.4% vs. 6.3%, P 〈 0.01), advanced fibrosis (46.8% vs. 29.5%, P = 0.04) and a history of anaemia during previous dual therapy (29.7% vs. 11.4%, P = 0.02). Patients developing severe anaemia were older (59 vs. 56 years, P = 0.02), had lower baseline platelet counts (134 vs. 163 × 10 9 /L, P = 0.04), haemoglobin (14.0 vs. 15.0 g/dl, P 〈 0.01), estimated glomerular filtration rate (79 vs. 90 ml/min/1.73 m 2 , P = 0.03) and a higher median ribavirin/weight ratio (14.9 vs. 13.2 mg/kg, P 〈 0.01). In multivariable logistic regression, presence of diabetes (OR = 5.61, 95% CI: 1.59–19.72), Fib‐4 ≥3.25 (OR = 3.09, 95% CI: 1.28–7.46), higher ribavirin/weight ratio (OR = 1.31 per mg/kg, 95% CI: 1.13–1.52) and lower baseline haemoglobin (OR = 0.57 per g/dl, 95% CI, 0.41–0.80) were independently associated with developing severe anaemia. Conclusions Severe anaemia occurred in one‐third of patients receiving telaprevir‐based triple therapy. Risk was greater in patients with diabetes, advanced liver fibrosis, higher ribavirin/weight ratio and lower baseline haemoglobin.
Type of Medium:
Online Resource
ISSN:
1478-3223
,
1478-3231
DOI:
10.1111/liv.2014.34.issue-7
Language:
English
Publisher:
Wiley
Publication Date:
2014
detail.hit.zdb_id:
2124684-1
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