Effect of viral suppression on hepatic venous pressure gradient in hepatitis C with cirrhosis and portal hypertension.
Identifieur interne : 000324 ( PubMed/Curation ); précédent : 000323; suivant : 000325Effect of viral suppression on hepatic venous pressure gradient in hepatitis C with cirrhosis and portal hypertension.
Auteurs : N. Afdhal [États-Unis] ; G T Everson [États-Unis] ; J L Calleja [Espagne] ; G W Mccaughan [Australie] ; J. Bosch [Espagne] ; D M Brainard [États-Unis] ; J G Mchutchison [États-Unis] ; S. De-Oertel [États-Unis] ; D. An [États-Unis] ; M. Charlton [États-Unis] ; K R Reddy [États-Unis] ; T. Asselah [France] ; E. Gane [Nouvelle-Zélande] ; M P Curry [États-Unis] ; X. Forns [Espagne]Source :
- Journal of viral hepatitis [ 1365-2893 ] ; 2017.
Abstract
Portal hypertension is a predictor of liver-related clinical events and mortality in patients with hepatitis C and cirrhosis. The effect of interferon-free hepatitis C treatment on portal pressure is unknown. Fifty patients with Child-Pugh-Turcotte (CPT) A and B cirrhosis and portal hypertension (hepatic venous pressure gradient [HVPG] >6 mm Hg) were randomized to receive 48 weeks of open-label sofosbuvir plus ribavirin at Day 1 or after a 24-week observation period. The primary endpoint was sustained virologic response 12 weeks after therapy (SVR12) in patients who received ≥1 dose of treatment. Secondary endpoints included changes in HVPG, laboratory parameters, and MELD and CPT scores. A subset of patients was followed 48 weeks posttreatment to determine late changes in HVPG. SVR12 occurred in 72% of patients (33/46). In the 37 patients with paired HVPG measurements at baseline and the end of treatment, mean HVPG decreased by -1.0 (SD 3.97) mm Hg. Nine patients (24%) had ≥20% decreases in HVPG during treatment. Among 39 patients with pretreatment HVPG ≥12 mm Hg, 27 (69%) achieved SVR12. Four of the 33 (12%) patients with baseline HVPG ≥12 mm Hg had HVPG <12 mm Hg at the end of treatment. Of nine patients with pretreatment HVPG ≥12 mm Hg who achieved SVR12 and completed 48 weeks of follow-up, eight (89%) had a ≥20% reduction in HVPG, and three reduced their pressure to <12 mm Hg. Patients with chronic HCV and compensated or decompensated cirrhosis who achieve SVR can have clinically meaningful reductions in HVPG at long-term follow-up. (EudraCT 2012-002457-29).
DOI: 10.1111/jvh.12706
PubMed: 28295923
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Gane</name><affiliation wicri:level="1"><nlm:affiliation>University of Auckland, Auckland, New Zealand.</nlm:affiliation><country xml:lang="fr">Nouvelle-Zélande</country><wicri:regionArea>University of Auckland, Auckland</wicri:regionArea></affiliation></author><author><name sortKey="Curry, M P" sort="Curry, M P" uniqKey="Curry M" first="M P" last="Curry">M P Curry</name><affiliation wicri:level="1"><nlm:affiliation>Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Beth Israel Deaconess Medical Center, Boston, Massachusetts</wicri:regionArea></affiliation></author><author><name sortKey="Forns, X" sort="Forns, X" uniqKey="Forns X" first="X" last="Forns">X. 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Afdhal</name><affiliation wicri:level="1"><nlm:affiliation>Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Beth Israel Deaconess Medical Center, Boston, Massachusetts</wicri:regionArea></affiliation></author><author><name sortKey="Everson, G T" sort="Everson, G T" uniqKey="Everson G" first="G T" last="Everson">G T Everson</name><affiliation wicri:level="1"><nlm:affiliation>University of Colorado Denver, Aurora, Colorado, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>University of Colorado Denver, Aurora, Colorado</wicri:regionArea></affiliation></author><author><name sortKey="Calleja, J L" sort="Calleja, J L" uniqKey="Calleja J" first="J L" last="Calleja">J L Calleja</name><affiliation wicri:level="1"><nlm:affiliation>Hospital U. Puerta de Hierro, CIBEREHD, Universidad Autonoma, Madrid, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Hospital U. Puerta de Hierro, CIBEREHD, Universidad Autonoma, Madrid</wicri:regionArea></affiliation></author><author><name sortKey="Mccaughan, G W" sort="Mccaughan, G W" uniqKey="Mccaughan G" first="G W" last="Mccaughan">G W Mccaughan</name><affiliation wicri:level="1"><nlm:affiliation>Royal Prince Alfred Hospital, Centenary Research Institute, University of Sydney, Sydney, NSW, Australia.</nlm:affiliation><country xml:lang="fr">Australie</country><wicri:regionArea>Royal Prince Alfred Hospital, Centenary Research Institute, University of Sydney, Sydney, NSW</wicri:regionArea></affiliation></author><author><name sortKey="Bosch, J" sort="Bosch, J" uniqKey="Bosch J" first="J" last="Bosch">J. Bosch</name><affiliation wicri:level="1"><nlm:affiliation>Liver Unit, Hospital Clinic, IDIBAPS, CIBEREHD, Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Liver Unit, Hospital Clinic, IDIBAPS, CIBEREHD, Barcelona</wicri:regionArea></affiliation></author><author><name sortKey="Brainard, D M" sort="Brainard, D M" uniqKey="Brainard D" first="D M" last="Brainard">D M Brainard</name><affiliation wicri:level="1"><nlm:affiliation>Gilead Sciences, Inc., Foster City, California, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Gilead Sciences, Inc., Foster City, California</wicri:regionArea></affiliation></author><author><name sortKey="Mchutchison, J G" sort="Mchutchison, J G" uniqKey="Mchutchison J" first="J G" last="Mchutchison">J G Mchutchison</name><affiliation wicri:level="1"><nlm:affiliation>Gilead Sciences, Inc., Foster City, California, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Gilead Sciences, Inc., Foster City, California</wicri:regionArea></affiliation></author><author><name sortKey="De Oertel, S" sort="De Oertel, S" uniqKey="De Oertel S" first="S" last="De-Oertel">S. De-Oertel</name><affiliation wicri:level="1"><nlm:affiliation>Gilead Sciences, Inc., Foster City, California, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Gilead Sciences, Inc., Foster City, California</wicri:regionArea></affiliation></author><author><name sortKey="An, D" sort="An, D" uniqKey="An D" first="D" last="An">D. An</name><affiliation wicri:level="1"><nlm:affiliation>Gilead Sciences, Inc., Foster City, California, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Gilead Sciences, Inc., Foster City, California</wicri:regionArea></affiliation></author><author><name sortKey="Charlton, M" sort="Charlton, M" uniqKey="Charlton M" first="M" last="Charlton">M. Charlton</name><affiliation wicri:level="1"><nlm:affiliation>Intermountain Medical Center, Murray, Utah, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Intermountain Medical Center, Murray, Utah</wicri:regionArea></affiliation></author><author><name sortKey="Reddy, K R" sort="Reddy, K R" uniqKey="Reddy K" first="K R" last="Reddy">K R Reddy</name><affiliation wicri:level="1"><nlm:affiliation>University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania</wicri:regionArea></affiliation></author><author><name sortKey="Asselah, T" sort="Asselah, T" uniqKey="Asselah T" first="T" last="Asselah">T. Asselah</name><affiliation wicri:level="1"><nlm:affiliation>Hôpital Beaujon, Department of Hepatology, AP-HP, INSERM UMR1149 and University Paris-Diderot, Clichy, France.</nlm:affiliation><country xml:lang="fr">France</country><wicri:regionArea>Hôpital Beaujon, Department of Hepatology, AP-HP, INSERM UMR1149 and University Paris-Diderot, Clichy</wicri:regionArea></affiliation></author><author><name sortKey="Gane, E" sort="Gane, E" uniqKey="Gane E" first="E" last="Gane">E. Gane</name><affiliation wicri:level="1"><nlm:affiliation>University of Auckland, Auckland, New Zealand.</nlm:affiliation><country xml:lang="fr">Nouvelle-Zélande</country><wicri:regionArea>University of Auckland, Auckland</wicri:regionArea></affiliation></author><author><name sortKey="Curry, M P" sort="Curry, M P" uniqKey="Curry M" first="M P" last="Curry">M P Curry</name><affiliation wicri:level="1"><nlm:affiliation>Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Beth Israel Deaconess Medical Center, Boston, Massachusetts</wicri:regionArea></affiliation></author><author><name sortKey="Forns, X" sort="Forns, X" uniqKey="Forns X" first="X" last="Forns">X. Forns</name><affiliation wicri:level="1"><nlm:affiliation>Liver Unit, Hospital Clinic, IDIBAPS, CIBEREHD, Barcelona, Spain.</nlm:affiliation><country xml:lang="fr">Espagne</country><wicri:regionArea>Liver Unit, Hospital Clinic, IDIBAPS, CIBEREHD, Barcelona</wicri:regionArea></affiliation></author></analytic><series><title level="j">Journal of viral hepatitis</title><idno type="eISSN">1365-2893</idno><imprint><date when="2017" type="published">2017</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Portal hypertension is a predictor of liver-related clinical events and mortality in patients with hepatitis C and cirrhosis. The effect of interferon-free hepatitis C treatment on portal pressure is unknown. Fifty patients with Child-Pugh-Turcotte (CPT) A and B cirrhosis and portal hypertension (hepatic venous pressure gradient [HVPG] >6 mm Hg) were randomized to receive 48 weeks of open-label sofosbuvir plus ribavirin at Day 1 or after a 24-week observation period. The primary endpoint was sustained virologic response 12 weeks after therapy (SVR12) in patients who received ≥1 dose of treatment. Secondary endpoints included changes in HVPG, laboratory parameters, and MELD and CPT scores. A subset of patients was followed 48 weeks posttreatment to determine late changes in HVPG. SVR12 occurred in 72% of patients (33/46). In the 37 patients with paired HVPG measurements at baseline and the end of treatment, mean HVPG decreased by -1.0 (SD 3.97) mm Hg. Nine patients (24%) had ≥20% decreases in HVPG during treatment. Among 39 patients with pretreatment HVPG ≥12 mm Hg, 27 (69%) achieved SVR12. Four of the 33 (12%) patients with baseline HVPG ≥12 mm Hg had HVPG <12 mm Hg at the end of treatment. Of nine patients with pretreatment HVPG ≥12 mm Hg who achieved SVR12 and completed 48 weeks of follow-up, eight (89%) had a ≥20% reduction in HVPG, and three reduced their pressure to <12 mm Hg. Patients with chronic HCV and compensated or decompensated cirrhosis who achieve SVR can have clinically meaningful reductions in HVPG at long-term follow-up. (EudraCT 2012-002457-29).</div></front></TEI><pubmed><MedlineCitation Status="In-Process" Owner="NLM"><PMID Version="1">28295923</PMID><DateCreated><Year>2017</Year><Month>03</Month><Day>15</Day></DateCreated><DateRevised><Year>2017</Year><Month>09</Month><Day>07</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1365-2893</ISSN><JournalIssue CitedMedium="Internet"><Volume>24</Volume><Issue>10</Issue><PubDate><Year>2017</Year><Month>Oct</Month></PubDate></JournalIssue><Title>Journal of viral hepatitis</Title><ISOAbbreviation>J. Viral Hepat.</ISOAbbreviation></Journal><ArticleTitle>Effect of viral suppression on hepatic venous pressure gradient in hepatitis C with cirrhosis and portal hypertension.</ArticleTitle><Pagination><MedlinePgn>823-831</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1111/jvh.12706</ELocationID><Abstract><AbstractText>Portal hypertension is a predictor of liver-related clinical events and mortality in patients with hepatitis C and cirrhosis. The effect of interferon-free hepatitis C treatment on portal pressure is unknown. Fifty patients with Child-Pugh-Turcotte (CPT) A and B cirrhosis and portal hypertension (hepatic venous pressure gradient [HVPG] >6 mm Hg) were randomized to receive 48 weeks of open-label sofosbuvir plus ribavirin at Day 1 or after a 24-week observation period. The primary endpoint was sustained virologic response 12 weeks after therapy (SVR12) in patients who received ≥1 dose of treatment. Secondary endpoints included changes in HVPG, laboratory parameters, and MELD and CPT scores. A subset of patients was followed 48 weeks posttreatment to determine late changes in HVPG. SVR12 occurred in 72% of patients (33/46). In the 37 patients with paired HVPG measurements at baseline and the end of treatment, mean HVPG decreased by -1.0 (SD 3.97) mm Hg. Nine patients (24%) had ≥20% decreases in HVPG during treatment. Among 39 patients with pretreatment HVPG ≥12 mm Hg, 27 (69%) achieved SVR12. Four of the 33 (12%) patients with baseline HVPG ≥12 mm Hg had HVPG <12 mm Hg at the end of treatment. Of nine patients with pretreatment HVPG ≥12 mm Hg who achieved SVR12 and completed 48 weeks of follow-up, eight (89%) had a ≥20% reduction in HVPG, and three reduced their pressure to <12 mm Hg. Patients with chronic HCV and compensated or decompensated cirrhosis who achieve SVR can have clinically meaningful reductions in HVPG at long-term follow-up. (EudraCT 2012-002457-29).</AbstractText><CopyrightInformation>© 2017 John Wiley & Sons Ltd.</CopyrightInformation></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Afdhal</LastName><ForeName>N</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Everson</LastName><ForeName>G T</ForeName><Initials>GT</Initials><AffiliationInfo><Affiliation>University of Colorado Denver, Aurora, Colorado, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Calleja</LastName><ForeName>J L</ForeName><Initials>JL</Initials><AffiliationInfo><Affiliation>Hospital U. Puerta de Hierro, CIBEREHD, Universidad Autonoma, Madrid, Spain.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>McCaughan</LastName><ForeName>G W</ForeName><Initials>GW</Initials><AffiliationInfo><Affiliation>Royal Prince Alfred Hospital, Centenary Research Institute, University of Sydney, Sydney, NSW, Australia.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Bosch</LastName><ForeName>J</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Liver Unit, Hospital Clinic, IDIBAPS, CIBEREHD, Barcelona, Spain.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Swiss Liver Center, Inselspital, Bern University, Bern, Switzerland.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Brainard</LastName><ForeName>D M</ForeName><Initials>DM</Initials><AffiliationInfo><Affiliation>Gilead Sciences, Inc., Foster City, California, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>McHutchison</LastName><ForeName>J G</ForeName><Initials>JG</Initials><AffiliationInfo><Affiliation>Gilead Sciences, Inc., Foster City, California, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>De-Oertel</LastName><ForeName>S</ForeName><Initials>S</Initials><AffiliationInfo><Affiliation>Gilead Sciences, Inc., Foster City, California, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>An</LastName><ForeName>D</ForeName><Initials>D</Initials><AffiliationInfo><Affiliation>Gilead Sciences, Inc., Foster City, California, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Charlton</LastName><ForeName>M</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Intermountain Medical Center, Murray, Utah, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Reddy</LastName><ForeName>K R</ForeName><Initials>KR</Initials><Identifier Source="ORCID">http://orcid.org/0000-0002-4898-7778</Identifier><AffiliationInfo><Affiliation>University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Asselah</LastName><ForeName>T</ForeName><Initials>T</Initials><AffiliationInfo><Affiliation>Hôpital Beaujon, Department of Hepatology, AP-HP, INSERM UMR1149 and University Paris-Diderot, Clichy, France.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Gane</LastName><ForeName>E</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>University of Auckland, Auckland, New Zealand.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Curry</LastName><ForeName>M P</ForeName><Initials>MP</Initials><AffiliationInfo><Affiliation>Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Forns</LastName><ForeName>X</ForeName><Initials>X</Initials><AffiliationInfo><Affiliation>Liver Unit, Hospital Clinic, IDIBAPS, CIBEREHD, Barcelona, Spain.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2017</Year><Month>04</Month><Day>10</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>J Viral Hepat</MedlineTA><NlmUniqueID>9435672</NlmUniqueID><ISSNLinking>1352-0504</ISSNLinking></MedlineJournalInfo><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">advanced liver disease</Keyword><Keyword MajorTopicYN="N">cirrhosis</Keyword><Keyword MajorTopicYN="N">decompensated cirrhosis</Keyword><Keyword MajorTopicYN="N">direct-acting antivirals</Keyword><Keyword MajorTopicYN="N">hepatic venous pressure gradient</Keyword><Keyword MajorTopicYN="N">portal hypertension</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2016</Year><Month>11</Month><Day>28</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2017</Year><Month>02</Month><Day>20</Day></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2017</Year><Month>3</Month><Day>16</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2017</Year><Month>3</Month><Day>16</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2017</Year><Month>3</Month><Day>16</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">28295923</ArticleId><ArticleId IdType="doi">10.1111/jvh.12706</ArticleId></ArticleIdList></PubmedData></pubmed></record>Pour manipuler ce document sous Unix (Dilib)
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