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Disadvantages of peginterferon and ribavirin treatment in older patients with chronic hepatitis C: an analysis using the propensity score

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Abstract

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.

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Abbreviations

PEG-IFN:

Peginterferon

RBV:

Ribavirin

CHC:

Chronic hepatitis C

HCV:

Hepatitis C virus

SVR:

Sustained viral response

HCC:

Hepatocellular carcinoma

PS:

Propensity score

RBC:

Red blood cells

PLT:

Hemoglobin: Hgb, platelets

WBC:

White blood cells

SNPs:

Single nucleotide polymorphisms

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Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan

    Hirotoshi Ebinuma, Hidetsugu Saito, Shinichiro Tada, Nobuhiro Nakamoto, Takanori Kanai & Toshifumi Hibi

  2. Department of Pharmacotherapeutics, Faculty of Pharmacy, Keio University, 1-5-30 Shiba-Kohen, Minato-ku, Tokyo, 105-8512, Japan

    Hidetsugu Saito

  3. The Center for Liver Diseases, Department of Internal Medicine, Kitasato Institute Hospital, Tokyo, Japan

    Tazuko Ohishi, Satoshi Tsunematsu, Naoki Kumagai & Kanji Tsuchimoto

  4. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Saiseikai Central Hospital, Tokyo, Japan

    Nobuhiro Tsukada

  5. Department of Internal Medicine, Nihon Kohkan Hospital, Kawasaki, Japan

    Yasutaka Inagaki

  6. Division of Gastroenterology and Hepatology, Department of Internal Medicine, Eiju General Hospital, Tokyo, Japan

    Yoshinori Horie

  7. Department of Gastroenterology and Hepatology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan

    Masahiko Takahashi

  8. Department of Gastroenterology and Hepatology, Hiratsuka City Hospital, Hiratsuka, Japan

    Kazuhiro Atsukawa

  9. Department of Internal Medicine, Sanokousei Hospital, Sano, Japan

    Yukishige Okamura

Authors
  1. Hirotoshi Ebinuma
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  2. Hidetsugu Saito
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  9. Nobuhiro Tsukada
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  15. Takanori Kanai
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  16. Toshifumi Hibi
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Corresponding author

Correspondence to Hidetsugu Saito.

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Ebinuma, H., Saito, H., Tada, S. et al. Disadvantages of peginterferon and ribavirin treatment in older patients with chronic hepatitis C: an analysis using the propensity score. Hepatol Int 6, 744–752 (2012). https://doi.org/10.1007/s12072-011-9312-9

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  • DOI: https://doi.org/10.1007/s12072-011-9312-9

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