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Diabetes mellitus and advanced liver fibrosis are risk factors for severe anaemia during telaprevir-based triple therapy.

Publication ,  Journal Article
Crismale, JF; Martel-Laferrière, V; Bichoupan, K; Schonfeld, E; Pappas, A; Wyatt, C; Odin, JA; Liu, LU; Schiano, TD; Perumalswami, PV ...
Published in: Liver Int
August 2014

BACKGROUND & AIMS: Adding 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. METHODS: An 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. RESULTS: The 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. 163×10(9) /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. CONCLUSIONS: Severe 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.

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Published In

Liver Int

DOI

EISSN

1478-3231

Publication Date

August 2014

Volume

34

Issue

7

Start / End Page

1018 / 1024

Location

United States

Related Subject Headings

  • Statistics, Nonparametric
  • Risk Factors
  • Ribavirin
  • Recombinant Proteins
  • Polyethylene Glycols
  • Oligopeptides
  • Odds Ratio
  • Multivariate Analysis
  • Logistic Models
  • Liver Cirrhosis
 

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Crismale, J. F., Martel-Laferrière, V., Bichoupan, K., Schonfeld, E., Pappas, A., Wyatt, C., … Branch, A. D. (2014). Diabetes mellitus and advanced liver fibrosis are risk factors for severe anaemia during telaprevir-based triple therapy. Liver Int, 34(7), 1018–1024. https://doi.org/10.1111/liv.12342
Crismale, James F., Valérie Martel-Laferrière, Kian Bichoupan, Emily Schonfeld, Alexis Pappas, Christina Wyatt, Joseph A. Odin, et al. “Diabetes mellitus and advanced liver fibrosis are risk factors for severe anaemia during telaprevir-based triple therapy.Liver Int 34, no. 7 (August 2014): 1018–24. https://doi.org/10.1111/liv.12342.
Crismale JF, Martel-Laferrière V, Bichoupan K, Schonfeld E, Pappas A, Wyatt C, et al. Diabetes mellitus and advanced liver fibrosis are risk factors for severe anaemia during telaprevir-based triple therapy. Liver Int. 2014 Aug;34(7):1018–24.
Crismale, James F., et al. “Diabetes mellitus and advanced liver fibrosis are risk factors for severe anaemia during telaprevir-based triple therapy.Liver Int, vol. 34, no. 7, Aug. 2014, pp. 1018–24. Pubmed, doi:10.1111/liv.12342.
Crismale JF, Martel-Laferrière V, Bichoupan K, Schonfeld E, Pappas A, Wyatt C, Odin JA, Liu LU, Schiano TD, Perumalswami PV, Bansal M, Dieterich DT, Branch AD. Diabetes mellitus and advanced liver fibrosis are risk factors for severe anaemia during telaprevir-based triple therapy. Liver Int. 2014 Aug;34(7):1018–1024.
Journal cover image

Published In

Liver Int

DOI

EISSN

1478-3231

Publication Date

August 2014

Volume

34

Issue

7

Start / End Page

1018 / 1024

Location

United States

Related Subject Headings

  • Statistics, Nonparametric
  • Risk Factors
  • Ribavirin
  • Recombinant Proteins
  • Polyethylene Glycols
  • Oligopeptides
  • Odds Ratio
  • Multivariate Analysis
  • Logistic Models
  • Liver Cirrhosis