Most Read Articles
Elvira Manzano, 6 days ago
Bisphosphonates have proven antifracture efficacy and remain to be the cornerstone of osteoporosis treatment. However, a drug holiday is of particular importance with bisphosphonates due to some signals with long-term use of the drug, including rare incidence of atypical femoral fracture (AFF) and osteonecrosis of the jaw (ONJ), says a leading endocrinologist at AFOS 2017.
Yesterday
Drinking coffee, whether caffeinated or decaffeinated, is associated with a reduced risk of cardiovascular disease (CVD) and ischaemic heart disease (IHD) mortality in patients with a prior myocardial infarction (MI), according to a recent study.
3 days ago
Breast cancer patients have notably different microbiomes in the local breast tissue and urinary tract, a recent study reveals. Particularly, species in the Methylobacterium genus are reduced in the local breast tissue while the urinary tract is enriched in gram-positive bacteria.
Pearl Toh, 13 Oct 2017
Women with higher plasma tryptophan concentrations were less likely to have poor sleep quality during pregnancy, especially among those with anxiety symptoms, according to the GUSTO* study.

Direct-acting antiviral treatment, SVR attainment reduce mortality in HCV

22 Aug 2017

Treatment with direct-acting antiviral regimens (paritaprevir/ritonavir, ombitasvir and dasabuvir [PrOD] or ledipasvir/sofosbuvir [LDV/SOF]) and attainment of sustained virologic response (SVR) are associated with a significant mortality benefit, which is evident within the first 18 months of treatment, in patients with hepatitis C virus (HCV) infection, a study has found.

Researchers examined a national cohort of HCV-infected veterans and identified 1,473 patients on PrOD and 5,497 on LDV/SOF. These patients were propensity score–matched to 6,970 untreated patients.   Exclusion criteria were infection with human immunodeficiency virus, hepatitis B surface antigen positivity, hepatocellular carcinoma, or missing HCV RNA or FIB-4 scores.

The main study outcome was survival, assessed using frequency of events, Kaplan-Meier curves and Cox proportional hazards regression analyses.

Compared with untreated patients, those who were on PrOD or LDV/SOF were more likely to be obese and have cirrhosis, but less likely to have stage 3 to 5 chronic kidney disease (CKD), alcohol or drug abuse or dependence diagnosis, and anaemia.

Significantly more patients died in the untreated group than in either treatment group (0.3 percent in PrOD and 1.4 percent in LDV/SOF vs 2.5 percent; p<0.001). Treated patients were more likely to survive to 18 months of follow-up compared with untreated controls (p<0.001).

Multivariable Cox regression analysis found treatment with either regimen and attainment of SVR to be associated with a significant reduction in mortality. The respective hazard ratios were 0.43 (95 percent CI, 0.33 to 0.57) and 0.57 (0.33 to 0.99).

Management of patients with chronic HCV infection is said to have been revolutionized by the development of newer oral direct-acting antiviral agents. Numerous agents are now approved for use in various combinations, showing reliability in terms of achieving SVR rates of >90 percent. [Aliment Pharmacol Ther 2016;43:1276–92; http://www.fda.gov/forpatients/illness/hepatitisbc/ucm408658.htm]

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Gastroenterology - Malaysia digital copy today!
DOWNLOAD
Editor's Recommendations
Most Read Articles
Elvira Manzano, 6 days ago
Bisphosphonates have proven antifracture efficacy and remain to be the cornerstone of osteoporosis treatment. However, a drug holiday is of particular importance with bisphosphonates due to some signals with long-term use of the drug, including rare incidence of atypical femoral fracture (AFF) and osteonecrosis of the jaw (ONJ), says a leading endocrinologist at AFOS 2017.
Yesterday
Drinking coffee, whether caffeinated or decaffeinated, is associated with a reduced risk of cardiovascular disease (CVD) and ischaemic heart disease (IHD) mortality in patients with a prior myocardial infarction (MI), according to a recent study.
3 days ago
Breast cancer patients have notably different microbiomes in the local breast tissue and urinary tract, a recent study reveals. Particularly, species in the Methylobacterium genus are reduced in the local breast tissue while the urinary tract is enriched in gram-positive bacteria.
Pearl Toh, 13 Oct 2017
Women with higher plasma tryptophan concentrations were less likely to have poor sleep quality during pregnancy, especially among those with anxiety symptoms, according to the GUSTO* study.