Georg Dultz1, Tobias Müller2, Jörg Petersen3, Stefan Mauss4, Tim Zimmermann5, Marion Muche2, Karl-Georg Simon6, Thomas Berg7, Stefan Zeuzem8, Dietrich Hüppe9, Klaus Böker10, Heiner Wedemeyer11,12,13, Tania M Welzel8. 1. Department of Medicine 1, J.W. Goethe University Frankfurt, Theodor-Stern-Kai 7, 60596, Frankfurt am Main, Germany. georg.dultz@kgu.de. 2. Charité Campus Virchow-Klinikum (CVK), Berlin, Germany. 3. ifi-Institute for Interdisciplinary Medicine, Hamburg, Germany. 4. Center for HIV and Hepatogastroenterology, Düsseldorf, Germany. 5. University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany. 6. Hepatologische Praxis, Leverkusen, Germany. 7. University Hospital Leipzig, Leipzig, Germany. 8. Department of Medicine 1, J.W. Goethe University Frankfurt, Theodor-Stern-Kai 7, 60596, Frankfurt am Main, Germany. 9. Hepatologische Schwerpunktpraxis, Herne, Germany. 10. Hepatologische Praxis, Hannover, Germany. 11. Department of Gastroenterology and Hepatology, University Hospital Essen, University of Duisburg Essen, Essen, Germany. 12. Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany. 13. Leberstiftungs-GmbH Deutschland, Hannover, Germany.
Abstract
BACKGROUND: With the aging of the hepatitis C virus (HCV)-infected patient cohort and the availability of highly effective and tolerable treatment regimens, an increasing number of elderly patients are now eligible for HCV therapy. This study investigated clinical and epidemiologic characteristics of elderly HCV-infected patients as well as the effectiveness and safety of available therapies. METHODS: Patients were enrolled into the German Hepatitis C Registry (DHC-R), a prospective, multicenter, real-world cohort study. Patients were treated at the discretion of the physician, and data were collected by a web-based system. RESULTS: Of 7133 patients who initiated treatment, 686 (9.6%) were > 70 years of age. In patients > 70 years, intent-to-treat (ITT) SVR12 was 92.6% (514/555) compared to 90.7% (4521/4985) in patients ≤ 70 years of age. Overall, adverse events (AEs) were reported in 374 (54.5%) and 3435 patients (53.3%) > 70 or ≤ 70 years of age; 7.6% (52) and 3.6% (235) in the respective age groups had a serious AE. Twenty-two (3.2%) and 62 (1.0%) of the patients > 70 or ≤ 70 years discontinued treatment due to AEs. Death was reported in 34 patients, of whom eight were > 70 years of age. Frequent comorbidities in patients > 70 years of age were cardiac disease, renal disease and diabetes. Psychiatric disorders, substance abuse and viral co-infection were more frequent in younger patients. CONCLUSION: Direct-acting antiviral therapies were well tolerated in patients older than 70 years. SVR12 rates in the elderly patient group were similar to those observed in younger patients. Differences in the prevalence of comorbidities between age groups warrant individualized attention with respect to drug-drug interactions and therapy adherence. The study was registered in the German Clinical Trials Register, DRKS-ID: DRKS00009717.
BACKGROUND: With the aging of the hepatitis C virus (HCV)-infected patient cohort and the availability of highly effective and tolerable treatment regimens, an increasing number of elderly patients are now eligible for HCV therapy. This study investigated clinical and epidemiologic characteristics of elderly HCV-infected patients as well as the effectiveness and safety of available therapies. METHODS: Patients were enrolled into the German Hepatitis C Registry (DHC-R), a prospective, multicenter, real-world cohort study. Patients were treated at the discretion of the physician, and data were collected by a web-based system. RESULTS: Of 7133 patients who initiated treatment, 686 (9.6%) were > 70 years of age. In patients > 70 years, intent-to-treat (ITT) SVR12 was 92.6% (514/555) compared to 90.7% (4521/4985) in patients ≤ 70 years of age. Overall, adverse events (AEs) were reported in 374 (54.5%) and 3435 patients (53.3%) > 70 or ≤ 70 years of age; 7.6% (52) and 3.6% (235) in the respective age groups had a serious AE. Twenty-two (3.2%) and 62 (1.0%) of the patients > 70 or ≤ 70 years discontinued treatment due to AEs. Death was reported in 34 patients, of whom eight were > 70 years of age. Frequent comorbidities in patients > 70 years of age were cardiac disease, renal disease and diabetes. Psychiatric disorders, substance abuse and viral co-infection were more frequent in younger patients. CONCLUSION: Direct-acting antiviral therapies were well tolerated in patients older than 70 years. SVR12 rates in the elderly patient group were similar to those observed in younger patients. Differences in the prevalence of comorbidities between age groups warrant individualized attention with respect to drug-drug interactions and therapy adherence. The study was registered in the German Clinical Trials Register, DRKS-ID: DRKS00009717.
Authors: T M Welzel; H Hinrichsen; C Sarrazin; P Buggisch; A Baumgarten; S Christensen; T Berg; S Mauss; G Teuber; K Stein; K Deterding; F van Bömmel; R Heyne; C John; T Zimmermann; T Lutz; E Schott; J Hettinger; H Kleine; B König; D Hüppe; H Wedemeyer Journal: J Viral Hepat Date: 2017-05-25 Impact factor: 3.728
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