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Disadvantages of peginterferon and ribavirin treatment in older patients with chronic hepatitis C: an analysis using the propensity score
Purpose Peginterferon (PEG-IFN) and ribavirin (RBV) combination treatment for patients with chronic hepatitis C (CHC), infected by genotype-1 hepatitis C virus with high viral loads, results in a sustained viral response (SVR) in ~50%. However, a trend of decreasing SVR in the older patients has bee...
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| Published in: | Hepatology international 2012-10, Vol.6 (4), p.744-752 |
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| Main Authors: | , , , , , , , , , , , , , , , |
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| container_end_page | 752 |
| container_issue | 4 |
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| container_title | Hepatology international |
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| creator | Ebinuma, Hirotoshi Saito, Hidetsugu Tada, Shinichiro Nakamoto, Nobuhiro Ohishi, Tazuko Tsunematsu, Satoshi Kumagai, Naoki Tsuchimoto, Kanji Tsukada, Nobuhiro Inagaki, Yasutaka Horie, Yoshinori Takahashi, Masahiko Atsukawa, Kazuhiro Okamura, Yukishige Kanai, Takanori Hibi, Toshifumi |
| description | Purpose
Peginterferon (PEG-IFN) and ribavirin (RBV) combination treatment for patients with chronic hepatitis C (CHC), infected by genotype-1 hepatitis C virus with high viral loads, results in a sustained viral response (SVR) in ~50%. However, a trend of decreasing SVR in the older patients has been reported. In the present study, we verified this trend of treatment efficacy in older patients using the propensity score (PS).
Methods
We conducted a survey of 327 patients with CHC (genotype 1 and high viral loads) who were treated with PEG-IFN and RBV for 48 weeks. The SVR rate was compared between patients =60 and |
| doi_str_mv | 10.1007/s12072-011-9312-9 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1699490097</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1699490097</sourcerecordid><originalsourceid>FETCH-LOGICAL-c405t-78781f1793f8aef9b5130f1afea6ea77edd8625f4778b6452fb1c1410a863b9c3</originalsourceid><addsrcrecordid>eNqFkU2LFDEQhoMo7jr6A7xIwIuX1lSS7nS8yfgJC1703KS7KzNZetJtKr3L_AT_tRlmXUQQISRVlafefLyMPQfxGoQwbwikMLISAJVVICv7gF2CVU0lag0P72OlLtgTomsh6rqB5jG7kFJI0cr2kv18H8iNNy5mt0Pis-cL7kLMmDymOXIXR55C725CCpHnhC4fMGZeknkaMfHF5VAKxG9D3vNhX5rCwPd4qudAfPu2aJThpiOVdKUQdzzvkS9pXjBSyEdOw5zwKXvk3UT47G7dsO8fP3zbfq6uvn76sn13VQ1a1LkyrWnBg7HKtw697WtQwoPz6Bp0xuA4to2svTam7RtdS9_DABqEaxvV20Ft2KuzbrnAjxUpd4dAA06Tiziv1EFjrbZCWPN_VKoWyicLVdCXf6HX85rKqwsFoK3WtZGFgjM1pJkooe-WFA4uHTsQ3cnS7mxpVyztTpaWacNe3Cmv_QHH-47fHhZAngEqW3GH6Y-j_6n6C5-VrWM</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1114944572</pqid></control><display><type>article</type><title>Disadvantages of peginterferon and ribavirin treatment in older patients with chronic hepatitis C: an analysis using the propensity score</title><source>Springer Nature</source><creator>Ebinuma, Hirotoshi ; Saito, Hidetsugu ; Tada, Shinichiro ; Nakamoto, Nobuhiro ; Ohishi, Tazuko ; Tsunematsu, Satoshi ; Kumagai, Naoki ; Tsuchimoto, Kanji ; Tsukada, Nobuhiro ; Inagaki, Yasutaka ; Horie, Yoshinori ; Takahashi, Masahiko ; Atsukawa, Kazuhiro ; Okamura, Yukishige ; Kanai, Takanori ; Hibi, Toshifumi</creator><creatorcontrib>Ebinuma, Hirotoshi ; Saito, Hidetsugu ; Tada, Shinichiro ; Nakamoto, Nobuhiro ; Ohishi, Tazuko ; Tsunematsu, Satoshi ; Kumagai, Naoki ; Tsuchimoto, Kanji ; Tsukada, Nobuhiro ; Inagaki, Yasutaka ; Horie, Yoshinori ; Takahashi, Masahiko ; Atsukawa, Kazuhiro ; Okamura, Yukishige ; Kanai, Takanori ; Hibi, Toshifumi</creatorcontrib><description>Purpose
Peginterferon (PEG-IFN) and ribavirin (RBV) combination treatment for patients with chronic hepatitis C (CHC), infected by genotype-1 hepatitis C virus with high viral loads, results in a sustained viral response (SVR) in ~50%. However, a trend of decreasing SVR in the older patients has been reported. In the present study, we verified this trend of treatment efficacy in older patients using the propensity score (PS).
Methods
We conducted a survey of 327 patients with CHC (genotype 1 and high viral loads) who were treated with PEG-IFN and RBV for 48 weeks. The SVR rate was compared between patients =60 and <60 years of age. Because backgrounds of these patients differed considerably, we verified this efficacy between the older (
n
= 102) and younger (
n
= 102) patients matched for gender, body weight, platelets (PLT), and red blood cell (RBC) counts using PS.
Results
The total SVR rate was 42.9% (161/327); this rate decreased with increasing age and was lower in the older patients (≥60 years: 41.5%, <60 years: 54.3%,
P
= 0.0245). Moreover, younger age was a significant factor for SVR. After correction by PS, the SVR in older patients remained significantly lower (≥60 years: 43.1%, <60 years: 57.8%,
P
= 0.0497). In addition, RBC counts and hemoglobin (Hgb) concentrations, as well as RBV adherence in the older patients, decreased with this treatment, although there were no significant differences in pretreatment RBC and Hgb levels.
Conclusions
The analysis using PS indicated that RBV adherence in the older patients decreased even if they did not have lower pretreatment RBC and Hgb levels.</description><identifier>ISSN: 1936-0533</identifier><identifier>EISSN: 1936-0541</identifier><identifier>DOI: 10.1007/s12072-011-9312-9</identifier><identifier>PMID: 22020828</identifier><language>eng</language><publisher>India: Springer-Verlag</publisher><subject>Age ; Body weight ; Colorectal Surgery ; Erythrocytes ; Genotypes ; Hemoglobin ; Hepatitis C ; Hepatitis C virus ; Hepatology ; Medicine ; Medicine & Public Health ; Original Article ; Platelets ; Ribavirin ; Surgery</subject><ispartof>Hepatology international, 2012-10, Vol.6 (4), p.744-752</ispartof><rights>Asian Pacific Association for the Study of the Liver 2011</rights><rights>Asian Pacific Association for the Study of the Liver 2012</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c405t-78781f1793f8aef9b5130f1afea6ea77edd8625f4778b6452fb1c1410a863b9c3</citedby><cites>FETCH-LOGICAL-c405t-78781f1793f8aef9b5130f1afea6ea77edd8625f4778b6452fb1c1410a863b9c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22020828$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ebinuma, Hirotoshi</creatorcontrib><creatorcontrib>Saito, Hidetsugu</creatorcontrib><creatorcontrib>Tada, Shinichiro</creatorcontrib><creatorcontrib>Nakamoto, Nobuhiro</creatorcontrib><creatorcontrib>Ohishi, Tazuko</creatorcontrib><creatorcontrib>Tsunematsu, Satoshi</creatorcontrib><creatorcontrib>Kumagai, Naoki</creatorcontrib><creatorcontrib>Tsuchimoto, Kanji</creatorcontrib><creatorcontrib>Tsukada, Nobuhiro</creatorcontrib><creatorcontrib>Inagaki, Yasutaka</creatorcontrib><creatorcontrib>Horie, Yoshinori</creatorcontrib><creatorcontrib>Takahashi, Masahiko</creatorcontrib><creatorcontrib>Atsukawa, Kazuhiro</creatorcontrib><creatorcontrib>Okamura, Yukishige</creatorcontrib><creatorcontrib>Kanai, Takanori</creatorcontrib><creatorcontrib>Hibi, Toshifumi</creatorcontrib><title>Disadvantages of peginterferon and ribavirin treatment in older patients with chronic hepatitis C: an analysis using the propensity score</title><title>Hepatology international</title><addtitle>Hepatol Int</addtitle><addtitle>Hepatol Int</addtitle><description>Purpose
Peginterferon (PEG-IFN) and ribavirin (RBV) combination treatment for patients with chronic hepatitis C (CHC), infected by genotype-1 hepatitis C virus with high viral loads, results in a sustained viral response (SVR) in ~50%. However, a trend of decreasing SVR in the older patients has been reported. In the present study, we verified this trend of treatment efficacy in older patients using the propensity score (PS).
Methods
We conducted a survey of 327 patients with CHC (genotype 1 and high viral loads) who were treated with PEG-IFN and RBV for 48 weeks. The SVR rate was compared between patients =60 and <60 years of age. Because backgrounds of these patients differed considerably, we verified this efficacy between the older (
n
= 102) and younger (
n
= 102) patients matched for gender, body weight, platelets (PLT), and red blood cell (RBC) counts using PS.
Results
The total SVR rate was 42.9% (161/327); this rate decreased with increasing age and was lower in the older patients (≥60 years: 41.5%, <60 years: 54.3%,
P
= 0.0245). Moreover, younger age was a significant factor for SVR. After correction by PS, the SVR in older patients remained significantly lower (≥60 years: 43.1%, <60 years: 57.8%,
P
= 0.0497). In addition, RBC counts and hemoglobin (Hgb) concentrations, as well as RBV adherence in the older patients, decreased with this treatment, although there were no significant differences in pretreatment RBC and Hgb levels.
Conclusions
The analysis using PS indicated that RBV adherence in the older patients decreased even if they did not have lower pretreatment RBC and Hgb levels.</description><subject>Age</subject><subject>Body weight</subject><subject>Colorectal Surgery</subject><subject>Erythrocytes</subject><subject>Genotypes</subject><subject>Hemoglobin</subject><subject>Hepatitis C</subject><subject>Hepatitis C virus</subject><subject>Hepatology</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Article</subject><subject>Platelets</subject><subject>Ribavirin</subject><subject>Surgery</subject><issn>1936-0533</issn><issn>1936-0541</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><recordid>eNqFkU2LFDEQhoMo7jr6A7xIwIuX1lSS7nS8yfgJC1703KS7KzNZetJtKr3L_AT_tRlmXUQQISRVlafefLyMPQfxGoQwbwikMLISAJVVICv7gF2CVU0lag0P72OlLtgTomsh6rqB5jG7kFJI0cr2kv18H8iNNy5mt0Pis-cL7kLMmDymOXIXR55C725CCpHnhC4fMGZeknkaMfHF5VAKxG9D3vNhX5rCwPd4qudAfPu2aJThpiOVdKUQdzzvkS9pXjBSyEdOw5zwKXvk3UT47G7dsO8fP3zbfq6uvn76sn13VQ1a1LkyrWnBg7HKtw697WtQwoPz6Bp0xuA4to2svTam7RtdS9_DABqEaxvV20Ft2KuzbrnAjxUpd4dAA06Tiziv1EFjrbZCWPN_VKoWyicLVdCXf6HX85rKqwsFoK3WtZGFgjM1pJkooe-WFA4uHTsQ3cnS7mxpVyztTpaWacNe3Cmv_QHH-47fHhZAngEqW3GH6Y-j_6n6C5-VrWM</recordid><startdate>20121001</startdate><enddate>20121001</enddate><creator>Ebinuma, Hirotoshi</creator><creator>Saito, Hidetsugu</creator><creator>Tada, Shinichiro</creator><creator>Nakamoto, Nobuhiro</creator><creator>Ohishi, Tazuko</creator><creator>Tsunematsu, Satoshi</creator><creator>Kumagai, Naoki</creator><creator>Tsuchimoto, Kanji</creator><creator>Tsukada, Nobuhiro</creator><creator>Inagaki, Yasutaka</creator><creator>Horie, Yoshinori</creator><creator>Takahashi, Masahiko</creator><creator>Atsukawa, Kazuhiro</creator><creator>Okamura, Yukishige</creator><creator>Kanai, Takanori</creator><creator>Hibi, Toshifumi</creator><general>Springer-Verlag</general><general>Springer Nature B.V</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7U7</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7U9</scope><scope>H94</scope><scope>7X8</scope></search><sort><creationdate>20121001</creationdate><title>Disadvantages of peginterferon and ribavirin treatment in older patients with chronic hepatitis C: an analysis using the propensity score</title><author>Ebinuma, Hirotoshi ; 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Peginterferon (PEG-IFN) and ribavirin (RBV) combination treatment for patients with chronic hepatitis C (CHC), infected by genotype-1 hepatitis C virus with high viral loads, results in a sustained viral response (SVR) in ~50%. However, a trend of decreasing SVR in the older patients has been reported. In the present study, we verified this trend of treatment efficacy in older patients using the propensity score (PS).
Methods
We conducted a survey of 327 patients with CHC (genotype 1 and high viral loads) who were treated with PEG-IFN and RBV for 48 weeks. The SVR rate was compared between patients =60 and <60 years of age. Because backgrounds of these patients differed considerably, we verified this efficacy between the older (
n
= 102) and younger (
n
= 102) patients matched for gender, body weight, platelets (PLT), and red blood cell (RBC) counts using PS.
Results
The total SVR rate was 42.9% (161/327); this rate decreased with increasing age and was lower in the older patients (≥60 years: 41.5%, <60 years: 54.3%,
P
= 0.0245). Moreover, younger age was a significant factor for SVR. After correction by PS, the SVR in older patients remained significantly lower (≥60 years: 43.1%, <60 years: 57.8%,
P
= 0.0497). In addition, RBC counts and hemoglobin (Hgb) concentrations, as well as RBV adherence in the older patients, decreased with this treatment, although there were no significant differences in pretreatment RBC and Hgb levels.
Conclusions
The analysis using PS indicated that RBV adherence in the older patients decreased even if they did not have lower pretreatment RBC and Hgb levels.</abstract><cop>India</cop><pub>Springer-Verlag</pub><pmid>22020828</pmid><doi>10.1007/s12072-011-9312-9</doi><tpages>9</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1936-0533 |
| ispartof | Hepatology international, 2012-10, Vol.6 (4), p.744-752 |
| issn | 1936-0533 1936-0541 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_1699490097 |
| source | Springer Nature |
| subjects | Age Body weight Colorectal Surgery Erythrocytes Genotypes Hemoglobin Hepatitis C Hepatitis C virus Hepatology Medicine Medicine & Public Health Original Article Platelets Ribavirin Surgery |
| title | Disadvantages of peginterferon and ribavirin treatment in older patients with chronic hepatitis C: an analysis using the propensity score |
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