Diabetes mellitus and advanced liver fibrosis are risk factors for severe anaemia during telaprevir-based triple therapy.
Diabetes mellitus and advanced liver fibrosis are risk factors for severe anaemia during telaprevir-based triple therapy.
复制标题
糖尿病和晚期肝纤维化是基于特拉匹韦的三联疗法期间发生严重贫血的危险因素。
DOI：
10.1111/liv.12342
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发表时间：
2014
期刊：
影响因子：
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通讯作者：
Branch,AndreaD
中科院分区：
文献类型：
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作者：
Crismale,JamesF;Martel-Laferrière,Valérie;Bichoupan,Kian;Schonfeld,Emily;Pappas,Alexis;Wyatt,Christina;Odin,JosephA;Liu,LawrenceU;Schiano,ThomasD;Perumalswami,PonniV;Bansal,Meena;Dieterich,DouglasT;Branch,AndreaD
Background & AimsAdding telaprevir to pegylated‐interferon and ribavirin increased both response rates and side effects of hepatitis C virus (HCV) treatment. We identified variables associated with severe anaemia during telaprevir‐based triple therapy.MethodsAn observational study was performed on 142 HCV‐infected patients between June 2011 and March 2012. All subjects completed 12 weeks of telaprevir‐based triple therapy or discontinued early because of anaemia. Severe anaemia was defined by a haemoglobin ≤8.9 g/dl; advanced fibrosis was determined by Fib‐4 ≥3.25.ResultsThe 47 (33%) patients who developed severe anaemia were similar to those who did not in sex, race, and prior response to dual therapy, but they were more likely to have diabetes (23.4% vs. 6.3%,P< 0.01), advanced fibrosis (46.8% vs. 29.5%,P= 0.04) and a history of anaemia during previous dual therapy (29.7% vs. 11.4%,P= 0.02). Patients developing severe anaemia were older (59 vs. 56 years,P= 0.02), had lower baseline platelet counts (134 vs. 163 × 109/L,P= 0.04), haemoglobin (14.0 vs. 15.0 g/dl,P< 0.01), estimated glomerular filtration rate (79 vs. 90 ml/min/1.73 m2,P= 0.03) and a higher median ribavirin/weight ratio (14.9 vs. 13.2 mg/kg,P< 0.01). In multivariable logistic regression, presence of diabetes (OR = 5.61, 95% CI: 1.59–19.72), Fib‐4 ≥3.25 (OR = 3.09, 95% CI: 1.28–7.46), higher ribavirin/weight ratio (OR = 1.31 per mg/kg, 95% CI: 1.13–1.52) and lower baseline haemoglobin (OR = 0.57 per g/dl, 95% CI, 0.41–0.80) were independently associated with developing severe anaemia.ConclusionsSevere anaemia occurred in one‐third of patients receiving telaprevir‐based triple therapy. Risk was greater in patients with diabetes, advanced liver fibrosis, higher ribavirin/weight ratio and lower baseline haemoglobin.
