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BMC Infect Dis:DAA治疗对临床实践的影响

2018-05-22 MedSci MedSci原创

研究证实基于选择中心网络的干预和根据疾病严重程度对患者进行优先排序是成功的。需要进一步的研究来确定DAAs治疗后的HCV的清除是否能够阻止或甚至逆转非肝硬化患者的肝纤维化程度,或者提高那些达到肝硬化SVR12患者的生活质量和预期寿命。

研究背景:在过去的几年中,慢性丙型肝炎(CHC)的管理得到显著改善。目前,第二代直接抗病毒药物(DAAs)可以清除大多数患者中的丙肝病毒。在此,研究呈现了第一次对DAAs临床网络数据进行分析的结果。

研究方法:该研究被设计为一个多中心队列:a)评估在临床网络活动的前24个月期间的治疗进展;b)报告治疗的总体疗效;c)分析与未获得病毒学反应(SVR12)相关的潜在因素d) 获得SVR12的患者与未获得SVR12的患者相比较,ALT水平的变化(基线和治疗12周后)。用多层混合效应logistic回归模型对疗效进行分析。采用混合效应模型混合模型对患者水平随机截距和随机坡度进行评价。也就是治疗之前或之后

研究结果:在2014年12月30号至2016年12月31号间,共计有5279例患者开始进行DAA治疗;其中,5127例患者(在14个临床中心)完成了为期12周的随访。在14个临床中心中,SVR12的总比例为93.41% (N = 4780)。由于严重副作用而中断治疗的患者很少(仅仅有23例患者)。未经调整的分析表明,SVR12的比例根据患者的基线特征发生了显著变化,但在调整了潜在的混杂因素之后,只有坚持目前的指导方针,肝脏疾病分期、性别、移植和艾滋病毒的状况与对治疗的反应是独立相关的。对ALT时间变化的分析表明,ALT水平在大多数获得SVR12的患者中是正常的,但不是在所有达到SVR12的患者中正常。

研究结论:研究证实基于选择中心网络的干预和根据疾病严重程度对患者进行优先排序是成功的。需要进一步的研究来确定DAAs治疗后的HCV的清除是否能够阻止或甚至逆转非肝硬化患者的肝纤维化程度,或者提高那些达到肝硬化SVR12患者的生活质量和预期寿命。

原始出处:

Lanini S, Scognamiglio P, Mecozzi A, et al. Impact of new DAA therapy on real clinical practice: a multicenter region-wide cohort study. BMC Infect Dis, 2018, 18(1), 223. doi: 10.1186/s12879-018-3125-6.

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    2018-05-24 qingting
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    2018-05-22 天地飞扬

    了解一下.谢谢分享!

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=2012682, encodeId=0cf72012682a5, content=<a href='/topic/show?id=7d69598468' target=_blank style='color:#2F92EE;'>#Dis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5984, encryptionId=7d69598468, topicName=Dis)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c689267, createdName=cmj8wellington, createdTime=Mon Aug 06 01:47:00 CST 2018, time=2018-08-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1974824, encodeId=c12719e4824fb, content=<a href='/topic/show?id=f145355379' target=_blank style='color:#2F92EE;'>#BMC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3553, encryptionId=f145355379, topicName=BMC)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdqq.qlogo.cn/qqapp/101173734/363C99735735B7F4CB11D5F78F580525/100, createdBy=aab22500211, createdName=ms3025846204744509, createdTime=Tue Oct 16 12:47:00 CST 2018, time=2018-10-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1324018, encodeId=a1e1132401800, content=<a href='/topic/show?id=42b922e7350' target=_blank style='color:#2F92EE;'>#临床实践#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=60, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22773, encryptionId=42b922e7350, topicName=临床实践)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=35fc2500023, createdName=yanjie6253_56072842, createdTime=Thu May 24 13:47:00 CST 2018, time=2018-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1361839, encodeId=3a8013618399e, content=<a href='/topic/show?id=a88b564ea6' target=_blank style='color:#2F92EE;'>#DAA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=87, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5647, encryptionId=a88b564ea6, topicName=DAA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e457184, createdName=qingting, createdTime=Thu May 24 13:47:00 CST 2018, time=2018-05-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=317649, encodeId=3dc331e64948, content=了解一下.谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cdnapi.center.medsci.cn/medsci/head/2019/12/23/2f51002e1349ccda5be11c1eea1e1e60.jpg, createdBy=a22097948, createdName=天地飞扬, createdTime=Tue May 22 23:24:20 CST 2018, time=2018-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=317641, encodeId=535631e641bc, content=不错的文章值得推荐一下, beContent=null, objectType=article, channel=null, level=null, likeNumber=80, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=04f22055142, createdName=131****2916, createdTime=Tue May 22 23:23:02 CST 2018, time=2018-05-22, status=1, ipAttribution=)]
    2018-05-22 131****2916

    不错的文章值得推荐一下

    0

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