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RISS 인기검색어
- 검색키워드
- 저자 : ( Elamin H. Elbasha ) (검색결과 1 건)
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( Chizoba Nwankwo ),( Shelby Corman ),( Elamin H. Elbasha ),( Sunju Kim ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1
Aims: Daclatasvir (DCV) plus Asunaprevir (ASV) is one of the current direct-acting antiviral (DAA) therapy treatment options for patients with chronic hepatitis C (CHC) genotype (GT) 1b patients in Korea. Elbasvir/grazoprevir (EBR/GZR) is an emerging DAA therapy for patients with CHC GT1b. The objective of this analysis was to estimate and compare the impact of EBR/GZR on long-term incidence of liver- related complications compared with DCV+ASV G1b CHC treated patients in South Korea. Methods: A computer-based Markov model of the natural history of chronic HCV (CHC) genotype 1 infection was developed to estimate the cumulative incidence of cirrhosis, decompensated cirrhosis (DC), hepatocellular carcinoma (HCC), liver-related deaths over a 30-year time horizon, and disease costs. The target population was G1b CHC treatment-naive and treatment-experienced infected patients. The model consisted of 16 health states encompassing METAVIR fibrosis score (F0-F4), treatment success or failure, DC, HCC, and liver-related death. Patients were assumed to be treated with 12 weeks of EBR/GZR (regardless of the presence of cirrhosis) or 24 weeks of DCV+ASV (based on Korean treatment guidelines). The proportions of patients achieving SVR for each treatment and subpopulation were obtained from clinical trials. The cost of disease management in Koreas was collected from published literature. Results: EBR/GZR was projected to reduce the cumulative incidence of cirrhosis to 1.6% compared with 8.3% for DCV+ASV. The cumulative incidence of DC and HCC were projected to be 8.2% and 6.4% respectively in patients treated with EBR/GZR compared with 10.1% and 7.5% respectively for DAC+ASV. This corresponded to a cumulative incidence of liver related death of 10.9% for EBR/GZR compared with 15.2% for DCV+ASV. The use of DCV+ASV also resulted in higher cumulative disease costs (4,267,442 KRW) compared with EBR/GZR (3,123,729 KRW). Conclusions: In Korea, the use of EBR/GZR for the treatment of CHC GT1b infected patients was projected to reduce the incidence of liver-related complications and mortality over a 30 year time horizon, compared with DCV+ASV. This was also estimated to lead to an increase in the cumulative disease costs that can be avoided when EBR/GZR is used to treat these patients compared with DCV+ASV in Korea.
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