HCV, Alcoholic : PE-136 ; Sustained virologic response (SVR) in prior peginterferon/ribavirin (PR) treatment failures after retreatment with boceprevir (BOC) + PR: The PROVIDE study interim results

( Jp Bronowicki ),( M Davis ),( S Flamm ),( S Gordon ),( E Lawitz ),( E Yoshida ),( J Galati ),( V Luketic ),( J Mccone ),( I Jacobson ),( P Marcellin ),( A Muir1 ),( F Poordad ),( Ld Pedicone ),( W D 대한간학회 2012 춘·추계 학술대회 (KASL) Vol.2012 No.-

Background: Patients in the PR control arms of BOC Phase 2/3 studies who did not achieve SVR could enroll in PROVIDE and receive BOC+PR. This interim analysis examines the preliminary efficacy and safety of BOC+PR in patients who failed prior treatment with PR. Methods: BOC (800 mg TID with food) was given with P 1.5 mcg/kg/week and weight-based R (600-1400 mg/day) BID for up to 44 weeks. If >2 weeks had elapsed since end of treatment in the previous study, PR was given for 4 weeks before adding BOC. Protocol specified analyses include patients who received at least one dose of BOC. Denominators for on-treatment response include patients who reached the specific time point or discontinued. The denominators for SVR include all patients who reached end of follow-up, discontinued, or were treatment failures. Results: Characteristics of 168 enrolled patients were: 67% male, 84% Caucasian, mean age 52 years, mean BMI 27.9 kg/m2, 77% high viral load (>800,000 IU/mL; mean log10 6.26); 10% cirrhotic; 61% subtype 1a. Table shows the proportion of BOC treated patients with undetectable HCV RNA at tested time points. SVR was achieved in 40% of prior null responders (<2 log10 decline in HCV RNA at TW12 in prior study) and 68% of prior partial responders/relapsers; 78% (38/49) of prior null responders and 24% (26/107) of prior partial responders/ relapsers had <1 log10 decline in HCV RNA after the PR lead in. Overall SVR was 47% in patients with <1 log10 decline with lower SVR rates in prior null responders (36%) vs. prior partial responders/relapsers (65%). 68% of patients with >1 log decline achieved SVR (55% prior null responders; 70% prior partial responders/relapsers). Seven percent of patients discontinued due to AEs, while 48% experienced anemia, 34% dysgeusia and 22% neutropenia. Conclusions: BOC+PR achieved high SVR rates regardless of prior response to PR. The degree of interferon responsiveness after PR lead in correlates with prior response and can help predict SVR for prior null responders. The safety profile is comparable to that previously reported for BOC+PR.

Energy-efficient coatings in the Nanohouse™ Initiative

M. J. Ford,G. B. Smith,C. Masens,J. Muir 한국물리학회 2004 Current Applied Physics Vol.4 No.2-4

The University of Technology Sydney (UTS), in collaboration with CSIRO has created the Nanohouse™ Initiative, a conceptthat serves as the conceptual framework for various pedagogical, scientic, architectural and engineering activities at the University. Housing is a signicant item in both personal and regional budgets, and the Nanohouse™ therefore serves as a powerful vehicle fordemonstrating nanotechnologies. One of the major energy-ecient components of the Nanohouse™ are nanoengineered coatingsand lms for transparent and translucent surfaces that modify their optical properties. These nanostructured materials can providewavelength-selective control of reection, absorption and transmission of light as well as angular selectivity for directional control,making it possible to design houses that have very large windows and skylights, but which nevertheless remain cool in summer andwarm in winter. We have already made signicant progress towards the development of these nanotechnologies. In this paper will bediscuss the design and performance of these optically controllable nanocoatings and their application to the Nanohouse™

Long-Term Course of Cirrhosis Regression: Lessons from Patients with HCV Cirrhosis Following Successful Sofosbuvir-Based Treatment

( Ira Jacobson ),( Andrew J. Muir ),( Eric Lawitz ),( Edward Gane ),( Brian Conway ),( Peter J. Ruane ),( Ziad Younes ),( Frances Chen ),( Marianne Camargo ),( Anand P. Chokkalingam ),( C. Stephen Dje 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1

Aims: In patients with HCV cirrhosis, a sustained virologic response (SVR) is associated with improved clinical outcomes; however, the temporal course of changes in fibrosis is poorly understood. Our aim was to evaluate changes in noninvasive tests of fibrosis (NITs) in this setting to gain insights into the natural history of cirrhosis regression following removal of the causative exposure. Methods: We studied patients with HCV cirrhosis who achieved SVR with sofosbuvir (SOF)-based regimens (in a trial or clinical practice) in an ongoing, prospective cirrhosis registry (NCT02292706). Patients underwent routine clinical and laboratory assessments, including semi-annual Child-Pugh-Turcotte (CPT) scoring and measurement of the Enhanced Liver Fibrosis (ELF) test, as well as annual liver stiffness measurement by transient elastography (LS by TE). Changes in fibrosis were estimated based on ELF response (defined as ≥0.5 unit reduction), and shifts in estimated fibrosis categories based on ELF (F3, ELF 9.8-11.3; F4, ELF >11.3) and LS by TE (F3, 9.6-12.5 kPa; F4, >12.5 kPa). Logistic regression was used to identify predictors of fibrosis improvement as defined by NITs. Results: 1,574 subjects with HCV cirrhosis (32% female, 39% BMI ≥30 kg/㎡, 7% CPT class B/C) were included in this study; median interval between SVR and registry enrollment was 38 weeks (IQR 27-60). At enrollment, median (IQR) ELF was 14.3 (9.5, 22.1); 586 (37%) and 247 (16%) patients had ELF scores consistent with F3 and F4 fibrosis, respectively. Median LS by TE was 9.9 kPa (9.2, 10.8); 761 (57%) and 227 (17%) patients had LS consistent with F3 and F4 fibrosis, respectively. As of May 2019, median duration of follow-up after registry enrollment was 123 weeks (IQR 96, 168). At week 144, 49% of those with baseline CPT class B/C had improved CPT class, while 98% of those with baseline CPT class A remained in CPT class A. During follow-up, changes in ELF and LS by TE suggested fibrosis improvement in an increasing proportion of patients with both F3 and F4 fibrosis at enrollment (Figure 1). ELF score improved by >0.5 units at week 144 in 27% and 47% of patients with baseline F3 and F4 fibrosis, respectively. Predictors of ELF improvement included higher ELF (P<0.001) and AST (P=0.049), and lower platelets (P=0.02) and BMI (P=0.10) at registry baseline. Conclusions: In patients with cirrhosis in whom HCV has been eradicated by SOF-based therapy, NITs suggest significant fibrosis improvement in 25-50% of patients within 3 years. Associations between reductions in these NITs and improvements in clinical outcomes require evaluation during longer-term follow-up.

HCV : PE-136 ; Sustained virologic response (SVR) in prior peginterferon/ribavirin (PR) treatment failures after retreatment with boceprevir (BOC) + PR: The PROVIDE study interim results

( Jp Bronowicki ),( M Davis ),( S Flamm ),( S Gordon ),( E Lawitz ),( E Yoshida ),( J Galati ),( V Luketic ),( J Mccone ),( Jacobson ),( P Marcellin ),( A Muir ),( F Poordad ),( Ld Pedicone ),( W Deng 대한간학회 2012 춘·추계 학술대회 (KASL) Vol.2012 No.1

Background: Patients in the PR control arms of BOC Phase 2/3 studies who did not achieve SVR could enroll in PROVIDE and receive BOC+PR. This interim analysis examines the preliminary efficacy and safety of BOC+PR in patients who failed prior treatment with PR. Methods: BOC (800 mg TID with food) was given with P 1.5 mcg/kg/week and weight-based R (600-1400 mg/day) BID for up to 44 weeks. If >2 weeks had elapsed since end of treatment in the previous study, PR was given for 4 weeks before adding BOC. Protocol specified analyses include patients who received at least one dose of BOC. Denominators for on-treatment response include patients who reached the specific time point or discontinued. The denominators for SVR include all patients who reached end of follow-up, discontinued, or were treatment failures. Results: Characteristics of 168 enrolled patients were: 67% male, 84% Caucasian, mean age 52 years, mean BMI 27.9 kg/m2, 77% high viral load (>800,000 IU/mL; mean log10 6.26); 10% cirrhotic; 61% subtype 1a. Table shows the proportion of BOC treated patients with undetectable HCV RNA at tested time points. SVR was achieved in 40% of prior null responders (<2 log10 decline in HCV RNA at TW12 in prior study) and 68% of prior partial responders/relapsers; 78% (38/49) of prior null responders and 24% (26/107) of prior partial responders/ relapsers had <1 log10 decline in HCV RNA after the PR lead in. Overall SVR was 47% in patients with <1 log10 decline with lower SVR rates in prior null responders (36%) vs. prior partial responders/relapsers (65%). 68% of patients with >1 log decline achieved SVR (55% prior null responders; 70% prior partial responders/relapsers). Seven percent of patients discontinued due to AEs, while 48% experienced anemia, 34% dysgeusia and 22% neutropenia. Conclusions: BOC+PR achieved high SVR rates regardless of prior response to PR. The degree of interferon responsiveness after PR lead in correlates with prior response and can help predict SVR for prior null responders. The safety profile is comparable to that previously reported for BOC+PR.

How to Implement the 3-Phase FODMAP Diet Into Gastroenterological Practice

Nessmah Sultan,Jane E Varney,Emma P Halmos,Jessica R Biesiekierski,Chu K Yao,Jane G Muir,Peter R Gibson,Caroline J Tuck 대한소화기 기능성질환·운동학회 2022 Journal of Neurogastroenterology and Motility (JNM Vol.28 No.3

Background/AimsThe 3-phase fermentable oligo-, di-, mono-saccharides, and polyols (FODMAP) diet has shown a high level of efficacy in irritable bowel syndrome, largely based on dietitian delivered education. However, access to dietitians can be limited, and challenges exist when applying the diet to a wide range of cultures, such as limited FODMAP analysis of local foods. This review aims to discuss ways to optimally use the FODMAP diet in practice in a wide range of cultures, directed at gastroenterologists from a dietitian’s perspective. MethodsRecent literature was analysed via search databases including Medline, CINAHL, PubMed and Scopus. ResultsThe dietetic process involves detailed assessment and follow-up through the 3 stages of the FODMAP diet (restriction, re-introduction, and long-term maintenance). Emerging evidence suggests the diet can be delivered by other health professionals such as the gastroenterologist or nurse, but training on how to do so successfully would be needed. Self-guided approaches through use of technology or specialised food delivery services may be an alternative when dietitians are not available, but efficacy data is limited. Regardless of delivery mode, nutritional and psychological risks of the diet must be mitigated. Additionally, culturally appropriate education must be provided, with accommodations necessary when the FODMAP content of local foods are unknown. ConclusionWhile the diet has shown improved irritable bowel syndrome outcomes across studies, it is important to acknowledge the essential role of dietitians in implementing, tailoring, and managing the diet to achieve the best outcome for each individual.