Superiority of interferon-free regimens for chronic Hepatitis C : the effect on health-related quality of life and work productivity

  • Patient-reported outcomes (PROs) such as quality of life and work productivity are important for measuring patient's experience. We assessed PROs during and after treatment of hepatitis C virus (HCV) patients.Data were obtained from a phase 3 open label study of sofosbuvir and ribavirin (SOF + RBV) with and without interferon (IFN). Patients completed 4 PRO assessment instruments (SF-36, Functional Assessment of Chronic Illness Therapy-Fatigue, Chronic Liver Disease Questionnaire- HCV, Work Productivity and Activity-Specific Health Problem) before, during, and after treatment.A total of 533 patients with chronic HCV were enrolled; 28.9% treatment-naïve, 23.1% cirrhotic, 219 received IFN + SOF + RBV and 314 received IFN-free SOF + RBV. At baseline, there were no differences in PROs between the IFN-free and IFN-containing treatment arms (all P > 0.05). During treatment, patients receiving IFN + SOF + RBV had a substantial impairment in their PROs (up to -24.4% by treatment week 12, up to -8.3% at week 4 post-treatment). The PRO decrements seen in the SOF + RBV arm were smaller in magnitude (up to -7.1% by treatment week 12), and all returned to baseline or improved by post-treatment week 4. By 12 weeks after treatment cessation, patients who achieved sustained viral response-12 showed some improvement of PRO scores regardless of the regimen (up to +7.1%, P < 0.0001) or previous treatment experience. In multivariate analysis, the use of IFN was independently associated with lower PROs.IFN-based regimens have a profoundly negative impact to PROs. By contrast, the impact of RBV on these PROs is relatively modest. Achieving HCV cure is associated with improvement of most of the PRO scores.

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Author:Zobair M. Younossi, Maria Stepanova, Rafael Esteban, Ira Jacobson, Stefan ZeuzemORCiDGND, Mark SulkowskiORCiDGND, Linda Henry, Fatema Nader, Rebecca Cable, Mariam Afendy, Sharon Hunt
URN:urn:nbn:de:hebis:30:3-428170
DOI:https://doi.org/10.1097/MD.0000000000005914
ISSN:1536-5964
ISSN:0025-7974
Pubmed Id:https://pubmed.ncbi.nlm.nih.gov/28207507
Parent Title (English):Medicine
Publisher:Lippincott Williams & Wilkins
Place of publication:Baltimore, Md.
Contributor(s):Ewa Janczewska
Document Type:Article
Language:English
Date of Publication (online):2017/05/04
Date of first Publication:2017/02/01
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2017/05/04
Tag:direct-acting antivirals; fatigue; work productivity
Volume:96
Issue:7, e5914
Page Number:6
First Page:1
Last Page:6
Note:
Copyright © 2017 the Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
HeBIS-PPN:425324257
Institutes:Medizin / Medizin
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Sammlungen:Universitätspublikationen
Licence (German):License LogoCreative Commons - Namensnennung 4.0