Chung-Feng Huang1, Etsuko Iio2, Dae Won Jun3, Eiichi Ogawa4, Hidenori Toyoda5, Yao-Chun Hsu6, Hiroaki Haga7, Shinji Iwane8, Masaru Enomoto9, Dong Hyun Lee10, Grace Wong11,12, Chen-Hua Liu13,14, Toshifumi Tada5, Wan-Long Chuang1, Ramsey Cheung15,16, Jun Hayashi17, Cheng-Hao Tseng6, Satoshi Yasuda5, Sally Tran15, Leslie Kam15, Linda Henry15, Jae Yoon Jeong18, Hideyuki Nomura19, Seung Ha Park20, Makoto Nakamuta21, Jee-Fu Huang1, Chi-Ming Tai6, Gin-Ho Lo6, Mei-Hsuan Lee22, Hwai-I Yang23, Jia-Horng Kao13,14, Akihiro Tamori9, Yuichiro Eguchi8, Yoshiyuki Ueno7, Norihiro Furusyo4, Yasuhito Tanaka2, Ming-Lung Yu1, Mindie H Nguyen24. 1. Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan. 2. Department of Virology and Liver Unit, Graduate School of Medical Sciences, Nagoya City University, Nagoya, Japan. 3. Department of Gastroenterology, Hanyang University, Seoul, South Korea. 4. Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan. 5. Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan. 6. Division of Gastroenterology and Hepatology, Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan. 7. Department of Gastroenterology, Faculty of Medicine, Yamagata University, Yamagata, Japan. 8. Liver Center, Saga University Hospital, Saga, Japan. 9. Department of Hepatology, Osaka City University Graduate School of Medicine, Osaka, Japan. 10. Department of Gastroenterology, Good Gang-An Hospital, Busan, South Korea. 11. Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, Hong Kong. 12. State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, Hong Kong. 13. Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan. 14. Hepatitis Research Center, National Taiwan University Hospital, Taipei, Taiwan. 15. Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University Medical Center, 750 Welch Road, Suite 210, Palo Alto, CA, 94304, USA. 16. Division of Gastroenterology and Hepatology, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA. 17. Kyushu General Internal Medicine Center, Haradoi Hospital, Fukuoka, Japan. 18. Department of Internal Medicine, Hanyang University College of Medicine, Guri Hospital, Guri, South Korea. 19. The Center for Liver Disease, Shin-Kokura Hospital, Kitakyushu, Japan. 20. Department of Internal Medicine, Inje University Haeundae Paik Hospital, Busan, South Korea. 21. Department of Gastroenterology, Kyushu Medical Center, National Hospital Organization, Fukuoka, Japan. 22. Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan. 23. Genomics Research Center, Academia Sinica, Taipei, Taiwan. 24. Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University Medical Center, 750 Welch Road, Suite 210, Palo Alto, CA, 94304, USA. mindiehn@stanford.edu.
Abstract
BACKGROUND AND AIMS: One-third of the global hepatitis C virus (HCV) burden is found in Asia. Real-world data from diverse East Asian cohorts remain limited. This study addressed the real-world status of direct-acting antiviral (DAA) therapy among patients from East Asia. METHODS: Chronic hepatitis C (CHC) patients from clinical sites in Japan, Taiwan, South Korea, and Hong Kong were recruited in the REAL-C registry, an observational chart review registry. The primary outcome was sustained virologic response (SVR12, HCV RNA PCR < 25 IU/mL 12 week post-therapy). RESULTS: A total of 6287 CHC patients were enrolled. Compared to other East Asian patients, patients from Japan were older (66.3 vs. 61.5 years, p < 0.0001), had lower body mass indices (22.9 kg/m2 vs. 24.6 kg/m2, p < 0.001), and were more likely to have non-liver malignancy history (12.2% vs. 5.0%, p < 0.001).The overall SVR12 rate was 96.4%, similar to patients both inside and outside Japan (96.6% vs. 96%, p = 0.21). The SVR12 rate ranged from 91.1 to 99.4% except treatment-experienced cirrhotic HCV genotype-1 patients who received daclatasvir/asunaprevir (85.9%) and the treatment-experienced cirrhotic HCV genotype-2 patients treated with sofosbuvir/ribavirin (87%). The overall rate of drug discontinuation was 1.9%, also similar across regions. On multivariate regression analyses, there was no significant association between geographic region and SVR outcomes. CONCLUSIONS: In this large multinational CHC cohort from the East Asia, oral DAAs were highly effective and well tolerated across the region. Policies should encourage treatment for all CHC patients with DAAs in Asia with its heavy burden of HCV.
BACKGROUND AND AIMS: One-third of the global hepatitis C virus (HCV) burden is found in Asia. Real-world data from diverse East Asian cohorts remain limited. This study addressed the real-world status of direct-acting antiviral (DAA) therapy among patients from East Asia. METHODS: Chronic hepatitis C (CHC) patients from clinical sites in Japan, Taiwan, South Korea, and Hong Kong were recruited in the REAL-C registry, an observational chart review registry. The primary outcome was sustained virologic response (SVR12, HCV RNA PCR < 25 IU/mL 12 week post-therapy). RESULTS: A total of 6287 CHC patients were enrolled. Compared to other East Asian patients, patients from Japan were older (66.3 vs. 61.5 years, p < 0.0001), had lower body mass indices (22.9 kg/m2 vs. 24.6 kg/m2, p < 0.001), and were more likely to have non-liver malignancy history (12.2% vs. 5.0%, p < 0.001).The overall SVR12 rate was 96.4%, similar to patients both inside and outside Japan (96.6% vs. 96%, p = 0.21). The SVR12 rate ranged from 91.1 to 99.4% except treatment-experienced cirrhotic HCV genotype-1 patients who received daclatasvir/asunaprevir (85.9%) and the treatment-experienced cirrhotic HCV genotype-2 patients treated with sofosbuvir/ribavirin (87%). The overall rate of drug discontinuation was 1.9%, also similar across regions. On multivariate regression analyses, there was no significant association between geographic region and SVR outcomes. CONCLUSIONS: In this large multinational CHC cohort from the East Asia, oral DAAs were highly effective and well tolerated across the region. Policies should encourage treatment for all CHC patients with DAAs in Asia with its heavy burden of HCV.
Entities:
Keywords:
CHC; DAA; Hong Kong; Japan; Korea; Taiwan
Authors: F Ji; B Wei; Y H Yeo; E Ogawa; B Zou; C D Stave; Z Li; S Dang; N Furusyo; R C Cheung; M H Nguyen Journal: Aliment Pharmacol Ther Date: 2018-01-12 Impact factor: 8.171
Authors: Young Min Kim; Suk Bae Kim; Il Han Song; Sae Hwan Lee; Hong Soo Kim; Tae Hee Lee; Young Woo Kang; Seok Hyun Kim; Byung Seok Lee; Hee Bok Chae; Myeong Jun Song; Ji Woong Jang; Soon Young Ko; Jae Dong Lee Journal: Clin Mol Hepatol Date: 2018-06-04