PMID- 28651903
OWN - NLM
STAT- MEDLINE
DCOM- 20180517
LR  - 20211204
IS  - 1878-3562 (Electronic)
IS  - 1590-8658 (Linking)
VI  - 49
IP  - 9
DP  - 2017 Sep
TI  - The elderly and direct antiviral agents: Constraint or challenge?
PG  - 1036-1042
LID - S1590-8658(17)30896-4 [pii]
LID - 10.1016/j.dld.2017.05.019 [doi]
AB  - BACKGROUND: Direct antiviral agents (DAAs) for chronic hepatitis C showed great 
      effectiveness and good safety profile. So far, few data are available about their 
      use in elderly subjects. AIM: To assess management, safety and outcome of DAAs 
      treatments in the elderly. METHODS: This retrospective, single-centre study 
      enrolled all patients aged >/=65 years, compared by age (group A: 65-74 years, 
      group B: >/=75 years), who completed DAAs between February 2015-November 2016. 
      Variables potentially associated to adverse events (AEs) were analyzed. Sustained 
      virological response (SVR) was evaluated at 12-weeks follow-up. RESULTS: DAAs 
      were administered to 221 patients aged >/=65 years (males: 112; group A: 130, group 
      B: 91). Prescribed regimens were: sofosbuvir-based: 44 patients (19.9%), 
      simeprevir-based: 25 (15%), ledipasvir-based: 49 (22.2%), daclatasvir-based: 12 
      (5.4%), paritaprevir/ritonavir+ombitasvir+/-dasabuvir: 91 (41.2%). Ribavirin was 
      used in 121 patients. In 58 subjects co-medications were adjusted due to drug 
      interactions. At least one AE occurred in 130 patients, including 13 SAEs, mainly 
      in older subjects (p=0.04). Female sex (p=0.04), liver stiffness (p=0.023), use 
      of simeprevir (p=0.03) and ribavirin (p=0.009) were associated with AEs. SVR-12 
      was achieved in 96,9% of subjects. CONCLUSIONS: A careful baseline evaluation and 
      a strict monitoring allow to optimise management and outcome of DAAs in elderly.
CI  - Copyright (c) 2017 Editrice Gastroenterologica Italiana S.r.l. Published by 
      Elsevier Ltd. All rights reserved.
FAU - Fabrizio, Claudia
AU  - Fabrizio C
AD  - Clinic of Infectious Diseases, University of Bari, University Hospital 
      Policlinico, Bari, Italy. Electronic address: claudia.fabrizio.82@gmail.com.
FAU - Saracino, Annalisa
AU  - Saracino A
AD  - Clinic of Infectious Diseases, University of Bari, University Hospital 
      Policlinico, Bari, Italy.
FAU - Scudeller, Luigia
AU  - Scudeller L
AD  - Scientific Direction, Clinical Epidemiology Unit, IRCCS San Matteo Foundation, 
      Pavia, Italy.
FAU - Milano, Eugenio
AU  - Milano E
AD  - Clinic of Infectious Diseases, University of Bari, University Hospital 
      Policlinico, Bari, Italy.
FAU - Dell'Acqua, Raffaele
AU  - Dell'Acqua R
AD  - Clinic of Infectious Diseases, University of Bari, University Hospital 
      Policlinico, Bari, Italy.
FAU - Bruno, Giuseppe
AU  - Bruno G
AD  - Clinic of Infectious Diseases, University of Bari, University Hospital 
      Policlinico, Bari, Italy.
FAU - Lo Caputo, Sergio
AU  - Lo Caputo S
AD  - Clinic of Infectious Diseases, University of Bari, University Hospital 
      Policlinico, Bari, Italy.
FAU - Monno, Laura
AU  - Monno L
AD  - Clinic of Infectious Diseases, University of Bari, University Hospital 
      Policlinico, Bari, Italy.
FAU - Milella, Michele
AU  - Milella M
AD  - Clinic of Infectious Diseases, University of Bari, University Hospital 
      Policlinico, Bari, Italy.
FAU - Angarano, Gioacchino
AU  - Angarano G
AD  - Clinic of Infectious Diseases, University of Bari, University Hospital 
      Policlinico, Bari, Italy.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20170601
PL  - Netherlands
TA  - Dig Liver Dis
JT  - Digestive and liver disease : official journal of the Italian Society of 
      Gastroenterology and the Italian Association for the Study of the Liver
JID - 100958385
RN  - 0 (Antiviral Agents)
RN  - 0 (Benzimidazoles)
RN  - 0 (Carbamates)
RN  - 0 (Fluorenes)
RN  - 0 (Imidazoles)
RN  - 0 (Pyrrolidines)
RN  - 013TE6E4WV (ledipasvir)
RN  - 49717AWG6K (Ribavirin)
RN  - 9WS5RD66HZ (Simeprevir)
RN  - HG18B9YRS7 (Valine)
RN  - LI2427F9CI (daclatasvir)
RN  - WJ6CA3ZU8B (Sofosbuvir)
SB  - IM
MH  - Aged
MH  - Antiviral Agents/adverse effects/*therapeutic use
MH  - Benzimidazoles/therapeutic use
MH  - Carbamates
MH  - Drug Interactions
MH  - Drug Therapy, Combination
MH  - Female
MH  - Fluorenes/therapeutic use
MH  - Hepacivirus
MH  - Hepatitis C, Chronic/*drug therapy
MH  - Humans
MH  - Imidazoles/therapeutic use
MH  - Italy
MH  - Logistic Models
MH  - Male
MH  - Pyrrolidines
MH  - Retrospective Studies
MH  - Ribavirin/therapeutic use
MH  - Simeprevir/therapeutic use
MH  - Sofosbuvir/therapeutic use
MH  - Sustained Virologic Response
MH  - Valine/analogs & derivatives
OTO - NOTNLM
OT  - Antiviral treatment
OT  - Chronic hepatitis C
OT  - HCV
EDAT- 2017/06/28 06:00
MHDA- 2018/05/18 06:00
CRDT- 2017/06/28 06:00
PHST- 2017/03/24 00:00 [received]
PHST- 2017/05/16 00:00 [revised]
PHST- 2017/05/22 00:00 [accepted]
PHST- 2017/06/28 06:00 [pubmed]
PHST- 2018/05/18 06:00 [medline]
PHST- 2017/06/28 06:00 [entrez]
AID - S1590-8658(17)30896-4 [pii]
AID - 10.1016/j.dld.2017.05.019 [doi]
PST - ppublish
SO  - Dig Liver Dis. 2017 Sep;49(9):1036-1042. doi: 10.1016/j.dld.2017.05.019. Epub 
      2017 Jun 1.