Disadvantages of peginterferon and ribavirin treatment in older patients with chronic hepatitis C: An analysis using the propensity score

Hirotoshi Ebinuma, Hidetsugu Saito, Shinichiro Tada, Nobuhiro Nakamoto, Tazuko Ohishi, Satoshi Tsunematsu, Naoki Kumagai, Kanji Tsuchimoto, Nobuhiro Tsukada, Yasutaka Inagaki, Yoshinori Horie, Masahiko Takahashi, Kazuhiro Atsukawa, Yukishige Okamura, Takanori Kanai, Toshifumi Hibi

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Abstract

Purpose Peginterferon (PEG-IFN) and ribavirin (RBV) combination treatment for patients with chronic hepatitis C (CHC), infected by genotype-1 hepatitis C virus with high viral loads, results in a sustained viral response (SVR) in 50%. However, a trend of decreasing SVR in the older patients has been reported. In the present study, we verified this trend of treatment efficacy in older patients using the propensity score (PS). Methods We conducted a survey of 327 patients with CHC (genotype 1 and high viral loads) who were treated with PEG-IFN and RBV for 48 weeks. The SVR rate was compared between patients =60 and <60 years of age. Because backgrounds of these patients differed considerably, we verified this efficacy between the older (n = 102) and younger (n = 102) patients matched for gender, body weight, platelets (PLT), and red blood cell (RBC) counts using PS. Results The total SVR rate was 42.9% (161/327); this rate decreased with increasing age and was lower in the older patients (C60 years: 41.5%, <60 years: 54.3%, P = 0.0245). Moreover, younger age was a significant factor for SVR. After correction by PS, the SVR in older patients remained significantly lower (C60 years: 43.1%, <60 years: 57.8%, P = 0.0497). In addition, RBC counts and hemoglobin (Hgb) concentrations, as well as RBV adherence in the older patients, decreased with this treatment, although there were no significant differences in pretreatment RBC and Hgb levels. Conclusions The analysis using PS indicated that RBV adherence in the older patients decreased even if they did not have lower pretreatment RBC and Hgb levels.

Original languageEnglish
Pages (from-to)744-752
Number of pages9
JournalHepatology International
Volume6
Issue number4
DOIs
Publication statusPublished - 2012 Oct 1

Keywords

  • Chronic hepatitis C
  • Propensity score
  • Ribavirin adherence
  • The combination treatment of peginterferon and ribavirin
  • The elderly patients

ASJC Scopus subject areas

  • Hepatology

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    Ebinuma, H., Saito, H., Tada, S., Nakamoto, N., Ohishi, T., Tsunematsu, S., Kumagai, N., Tsuchimoto, K., Tsukada, N., Inagaki, Y., Horie, Y., Takahashi, M., Atsukawa, K., Okamura, Y., Kanai, T., & Hibi, T. (2012). Disadvantages of peginterferon and ribavirin treatment in older patients with chronic hepatitis C: An analysis using the propensity score. Hepatology International, 6(4), 744-752. https://doi.org/10.1007/s12072-011-9312-9