Efficacy and safety of glecaprevir and pibrentasvir combination therapy in old-aged patients with chronic hepatitis C virus infection

Shunji WATANABE; Naoki MORIMOTO; Kouichi MIURA; Toshimitsu MUROHISA; Toshiyuki TAHARA; Takashi SATO; Shigeo TANO; Yukimura FUKAYA; Hidekazu KURATA; Yukishige OKAMURA; Norikatsu NUMAO; Keita UEHARA; Kozue MURAYAMA; Katsuyuki NAKAZAWA; Hitoshi SUGAYA; Hiroaki YOSHIZUMI; Makoto IIJIMA; Mamiko TSUKUI; Takuya HIROSAWA; Yoshinari TAKAOKA; Hiroaki NOMOTO; Hiroshi MAEDA; Rie GOKA; Norio ISODA; Hironori YAMAMOTO

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Efficacy and safety of glecaprevir and pibrentasvir combination therapy in old-aged patients with chronic hepatitis C virus infection

VernacularTitle:Efficacy and safety of glecaprevir and pibrentasvir combination therapy in old-aged patients with chronic hepatitis C virus infection
Author: Shunji WATANABE ¹ ; Naoki MORIMOTO ¹ ; Kouichi MIURA ¹ ; Toshimitsu MUROHISA ² ; Toshiyuki TAHARA ³ ; Takashi SATO ⁴ ; Shigeo TANO ⁵ ; Yukimura FUKAYA ⁶ ; Hidekazu KURATA ⁷ ; Yukishige OKAMURA ⁸ ; Norikatsu NUMAO ⁹ ; Keita UEHARA ¹⁰ ; Kozue MURAYAMA ¹¹ ; Katsuyuki NAKAZAWA ¹² ; Hitoshi SUGAYA ¹³ ; Hiroaki YOSHIZUMI ¹⁴ ; Makoto IIJIMA ¹⁵ ; Mamiko TSUKUI ² ; Takuya HIROSAWA ¹⁶ ; Yoshinari TAKAOKA ¹ ; Hiroaki NOMOTO ¹ ; Hiroshi MAEDA ¹ ; Rie GOKA ¹ ; Norio ISODA ¹ ; Hironori YAMAMOTO ¹
Author Information

1. Department of Medicine, Division of Gastroenterology, Jichi Medical University, Japan
2. Department of Gastroenterology, Dokkyo Medical University, Japan
3. Department of Gastroenterology, Saiseikai Utsunomiya Hospital, Japan
4. Department of Gastroenterology, Nasu Red Cross Hospital, Japan
5. Department of Gastroenterology, Shin-Oyama City Hospital, Japan
6. Department of Internal Medicine, Nasu Minami Hospital, Japan
7. Department of Gastroenterology, Tochigi Medical Center Shimotsuga, Japan
8. Department of Gastroenterology, Sano Kousei General Hospital, Japan
9. Department of Gastroenterology, Haga Red Cross Hospital, Japan
10. Department of Gastroenterology, Tochigi Medical Center, Japan
11. Department of Gastroenterology, Koga Red Cross Hospital, Japan
12. Department of Gastroenterology, JCHO Utsunomiya Hospital, Japan
13. Department of Internal Medicine, Utsunomiya Higashi Hospital, Japan
14. Department of Gastroenterology, Ashikaga Red Cross Hospital, Japan
15. Department of Internal Medicine, Kamitsuga General Hospital, Japan
16. Department of Gastroenterology, Yuai Memorial Hospital, Japan
Keywords: age disparities; chronic hepatitis C; glecaprevir; pibrentasvir
From:Journal of Rural Medicine 2020;15(4):139-145
CountryJapan
Language:English
Abstract: Objective: Combination therapy with glecaprevir and pibrentasvir (G/P) has been shown to provide a sustained virologic response (SVR) rate of >97% in patients with chronic hepatitis C virus (HCV) infection in the first published real-world Japanese data. However, a recently published study showed that the treatment was often discontinued in patients ≥75 years old, resulting in low SVR in intention-to-treat (ITT) analysis. Thus, our aim was to evaluate real-world data for G/P therapy in patients ≥75 years of age, the population density of which is high in “rural” regions.Patients and Methods: We conducted a multicenter study to assess the efficacy and safety of G/P therapy for chronic HCV infection, in the North Kanto area in Japan.Results: Of the 308 patients enrolled, 294 (95.5%) completed the treatment according to the protocol. In ITT and per-protocol analyses, the overall SVR12 rate was 97.1% and 99.7%, respectively. The old-aged patients group consisted of 59 participants, 56 of whom (94.9%) completed the scheduled protocol. Although old-aged patients tended to have non-SVR factors such as liver cirrhosis, history of HCC, and prior DAA therapies, the SVR12 rates in old-aged patients were 98.3% and 100% in the ITT and PP analyses, respectively. Of 308 patients enrolled, adverse events were observed in 74 patients (24.0%), with grade ≥3 events in 8 patients (2.6%). There was no significant difference in any grade and grade ≥3 adverse events between the old-aged group and the rest of the study participants. Only one patient discontinued the treatment because of adverse events.Conclusion: G/P therapy is effective and safe for old-aged patients.