Efficacy and Safety of Direct-Acting Antivirals in Elderly Patients with Chronic Hepatitis C: A Nationwide Real-Life, Observational, Multicenter Study from Turkey.
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Önlen Yusuf, Bal Tayibe, Çabalak Mehmet, Çuvalcı Öztoprak Nefise, Sarı Nagehan Didem, Kurtaran Behice, Şenateş Ebubekir, Gündüz Alper, Zerdali Esra, Karsen Hasan, Batırel Ayşe, Karaali Rıdvan, Güner Rahmet, Yamazhan Tansu, Köse Şükran, Erben Nurettin, İnce Nevin, Köksal İftihar, Sarıgül Yıldırım Figen, Yörük Gülşen, Kömür Süheyla, Kaya Sibel, Esen Şaban, Günal Özgür, Esen Yıldız İlknur, İnan Dilara, Barut Şener, Namıduru Mustafa, Tosun Selma, Türker Kamuran, Şener Alper, Hızel Kenan, Baykam Nurcan, Duygu Fazilet, Akıncı Esragül, Can Güray, User Ülkü, Gül Hanefi Cem, Akbulut Ayhan, Çelebi Güven, Sünnetçioğlu Mahmut, Karabay Oğuz, Kumbasar Karaosmanoğlu Hayat, Sırmatel Fatma, Tabak Fehmi
Аннотация
METHODS: In this multicenter prospective study, 2629 eligible chronic hepatitis C patients treated with direct-acting antivirals between April 2017 and December 2019 from 37 Turkish referral centers were divided into 2 age groups: elderly (≥65 years) and younger adults (<65 years) and their safety was compared between 2 groups in evaluable population. Then, by matching the 2 age groups for demographics and pretreatment risk factors for a non-sustained virological response, a total of 1516 patients (758 in each group) and 1244 patients (622 in each group) from the modified evaluable population and per-protocol population were included in the efficacy analysis and the efficacy was compared between age groups.
RESULTS: The sustained virological response in the chronic hepatitis C patients was not affected by the age and the presence of cirrhosis both in the modified evaluable population and per-protocol population (P = .879, P = .508 for modified evaluable population and P = .058, P = .788 for per-protocol population, respectively). The results of the per-protocol analysis revealed that male gender, patients who had a prior history of hepatocellular carcinoma, patients infected with non-genotype 1 hepatitis C virus, and patients treated with sofosbuvir+ribavirin had a significantly lower sustained virological response 12 rates (P < .001, P = .047, P = .013, and P = .025, respectively).
CONCLUSION: Direct-acting antivirals can be safely used to treat Turkish elderly chronic hepatitis C patients with similar favorable efficacy and safety as that in younger adults.