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Treatment of hepatitis C with direct-acting antivirals significantly reduces liver-related hospitalizations in patients with cirrhosis

Hill, Lucas A ; Delmonte, Ronnie J ; Andrews, Barbara ; Richards, Lisa ; Soto, Robin ; Collier, Summer ; Kuo, Alexander ; Cachay, Edward

European journal of gastroenterology & hepatology, 2018-11, Vol.30 (11), p.1378-1383 [Periódico revisado por pares]

England: Copyright Wolters Kluwer Health, Inc. All rights reserved

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Título:
Treatment of hepatitis C with direct-acting antivirals significantly reduces liver-related hospitalizations in patients with cirrhosis
Autor: Hill, Lucas A ; Delmonte, Ronnie J ; Andrews, Barbara ; Richards, Lisa ; Soto, Robin ; Collier, Summer ; Kuo, Alexander ; Cachay, Edward
Assuntos: Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antiviral Agents - economics ; Antiviral Agents - therapeutic use ; California ; Cost Savings ; Cost-Benefit Analysis ; Drug Costs ; Female ; Hepatitis C - complications ; Hepatitis C - diagnosis ; Hepatitis C - drug therapy ; Hepatitis C - mortality ; Hospital Costs ; Hospitalization - economics ; Humans ; Liver Cirrhosis - diagnosis ; Liver Cirrhosis - drug therapy ; Liver Cirrhosis - mortality ; Liver Cirrhosis - virology ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors ; Time Factors ; Treatment Outcome ; Young Adult
É parte de: European journal of gastroenterology & hepatology, 2018-11, Vol.30 (11), p.1378-1383
Notas: ObjectType-Article-1
SourceType-Scholarly Journals-1
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Descrição: BACKGROUNDThe availability of direct-acting antivirals (DAA) for the treatment of hepatitis C (HCV) has resulted in the ability to safely and effectively treat patients with cirrhosis and end-stage liver disease. However, information is limited with regard to the impact of DAA treatment on inpatient health-related resource utilization in patients with advanced HCV-related cirrhosis. We aimed to ascertain the impact of DAA treatment on the frequency of liver-related hospitalizations and associated costs in patients with cirrhosis. PATIENTS AND METHODSRetrospective cohort analysis carried out at a single US reference center that compared patients with HCV cirrhosis according to treatment statusthe untreated group (January 2011 to December 2013) and the DAA-treated group (January 2014 to March 2017). The primary outcome was the difference in the incidence rate of liver-related hospitalizations. Secondary outcomes included differences in the incidence of hepatocellular carcinoma, liver transplant, and all-cause mortality. We calculated the projected savings per-patient treated per-year on the basis of calculated hospitalization rate stratified by Child–Turquotte–Pugh (CTP) score. RESULTSBaseline characteristics were similar between the untreated (n=182) and DAA-treated (n=196) cohorts. Mean follow-up time in the untreated and treated cohort was 20.4 and 17.7 months, respectively. The incidence rates of liver-related hospitalizations were 29.1/100 and 10.4/100 person-years of follow-up (P≤0.0001) in the untreated and treated cohorts, respectively. This was accounted for by a decreased incidence of hospitalizations in patients with CTP-A (75.8%) and CTP-B (64.5%), but not CTP-C. CONCLUSIONSuccessful DAA treatment reduces hospitalization rate and resource utilization costs in patients with CTP-A and CTP-B, but not in those with CTP-C.
Editor: England: Copyright Wolters Kluwer Health, Inc. All rights reserved
Idioma: Inglês

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Treatment of hepatitis C with direct-acting antivirals significantly reduces liver-related hospitalizations in patients with cirrhosis

Hill, Lucas A ; Delmonte, Ronnie J ; Andrews, Barbara ; Richards, Lisa ; Soto, Robin ; Collier, Summer ; Kuo, Alexander ; Cachay, Edward

England: Copyright Wolters Kluwer Health, Inc. All rights reserved

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