PE-049 : Impact of Interferon-Based Treatment on Quality of Life and Work Related Productivity from the Korean Cohort in the MOSAIC Study

( Sang Hoon Ahn ),( Won Hyeok Choe ),( Yoon Jun Kim ),( Jeong Heo ),( Dorota Latarska-smuga ),( Jiho Kang ),( Seung Woon Paik ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1

Aims: Chronic Hepatitis C Virus (HCV) infection increases the risk for progressive liver disease, hepatocellular carcinoma and negatively impacts the patient’s quality of life. HCV treatment is evolving with direct acting antivirals but IFN based therapy has been the standard of care for many years and remains available in some countries. The MOSAIC study aims to characterize patients with chronic HCV infection and assess the impact of IFN-containing treatment on health-related quality of life, work related productivity and health care utilization. Methods: MOSAIC is an international prospective multicenter observational study that has been conducted in 20 countries. Consecutive patients with chronic HCV infection were enrolled and those who initiated an IFN based regimen were prospectively followed for 48 weeks. We report results from the Korean cohort Results: 100 patients were enrolled: 86 were treatment naïve and 14 were treatment experienced. 33 patients initiated an IFN based regimen: 6 patients started IFN + RBV, 26 patients started Peg-IFN + RBV, none started Peg-IFN + RBV + DAA and 1 patient received other treatment. Among the treated cohort, demographic and disease characteristics were the following: the mean age was 54.5 years; 14 patients were male. 14 had minimal or no fibrosis, 2 portal fibrosis, 3 bridging fibrosis and 6 patients suffered from cirrhosis. HCV Genotype distribution was as follows: genotype 1: 11; genotype 2: 19 and genotype 3: 3. Table 1 describes the results at baseline and changes over 4, 12 and 48 weeks and end-of-treatment (EOT) for the quality of life and work productivity outcome measures (EQ-5D-5L, HCV-PRO and WPAI). Conclusions: Results from the Korean cohort of the MOSAIC study show a moderate trend for deterioration of health-related quality of life and work productivity associated with IFN based treatment for patients with chronic HCV infection during treatment period. Acknowledgements: The design, study conduct, analysis, and financial support of MOSAIC study were provided by AbbVie. AbbVie participated in the interpretation of data, review, and approval of the content of the abstract. All authors had access to all relevant data and participated in writing, review, and approval of this abstract. Medical writing support was provided by Olivier Van de Steen of Medeor-consulting, funded by AbbVie. Disclosures: Sang Hoon Ahn: served as an advisor and lecturer for Bristol-Myers Squibb, Gilead Sciences, F.Hoffmann-La Roche, Merck, AbbVie, and has received unrestricted grants from Bristol-Myers Squibb, Gilead Sciences, and F. Hoffmann-La Roche for investigator- initiated trials Won Hyeok Choe: Nothing to disclosure Yoon Jun Kim: Nothing to disclosure Jeong Heo: received a grant from GSK; Research support from BMS, and Roche; Advisor for Abbvie, BMS, Gilead Sciences, Pharma Essentia, SillaJen, and Johnson & Johnson. Dorota Latarska-Smuga, Jiho Kang: are employees of AbbVie, Inc. and may hold stock or stock options. Seung Woon Paik: received grant and research support from AbbVie, BMS, Gilead, GSK, Merck, Novartis, and Roche

라미부딘 치료에 내성을 보인 환자에서 엔테카비어의 항바이러스 효과와 바이러스 변이 발생에 관한 연구

Won Hyeok Choe,So Young Kwon,Byung Kook Kim,Soon Young Ko,Young Kul Jung,Jong Eun Yeon,Kwan Soo Byun,Wangdon Yoo,Soo Ok Kim,Sun Pyo Hong,Chang Hong Lee 대한간학회 2008 Clinical and Molecular Hepatology(대한간학회지) Vol.14 No.3(S)

Is multidisciplinary treatment effective for hepatocellular carcinoma with portal vein tumor thrombus?

( Won Hyeok Choe ) 대한간암학회 2022 대한간암학회지 Vol.22 No.1

Disorders of Liver : Is Endoscopic Variceal Ligation Effective For The Treatment Of Bleeding From Gastroesophageal Varices (GOV)?

( Won Hyeok Choe ),( So Young Kwon ),( Jeong Hwan Kim ),( Byung Kook Kim ),( Chi Hoon Kim ),( Chang Hong Lee ) 대한소화기학회 2007 SIDDS Vol.9 No.-

Background/Aims: The optimal management of bleeding from gastroesophageal varices (GOV) remains controversial. The aim of this study was to investigate whether endoseopic variceal ligation (EVL) is effective and safe for the management of bleeding from GOV. Methods: Forty-one cirrhotic patients receiving EVL due to a history of variceal bleeding from GOV were analyzed. In twenty-two patients of them, serial endoseopic ultrasonography (EUS) were performed. GOV were grade using the system suggested by Sarin et al: type I (GOVI) and type 2 (GOV2). Results: Twenty-eight patients were GOVI and thirteen patients were GOV2. Successful treatment for controlling acute bleeding were achieved in 26/28 (93%) in GOVI and 9/13 (85%) in GOV2. Rebleeding was 15% in GOVI, while 40% in GOV2. Multivariate Cox regression indicated that type of GOV, variceal size and residual variceal size after EVL were independent factors predictive of GOV re-bleeding. Serial EUS findings demonstrated that the size of GOVI became decreased after EVL in 10/15 (67%) patients, while GOV2 did not change. Conclusions: EVL was safe and effective for the emergency treatment of acutely variceal bleedings from GOV. For the preventing variceal rebleeding, EVL was more effective in GOVI than GOV2.

Poster Exhibition : Limited Efficacy of Entecavir Rescue in Patients Who Previously Failed Lamivudine and Adefovir Therapy (초)

Won Hyeok Choe,So Young Kwon,Byung Kook Kim,Soon Young Ko,Jong Eun Yeon,Kwan Soo Byun,Chang Hong Lee 대한간학회 2009 Clinical and Molecular Hepatology(대한간학회지) Vol.15 No.4(S)

The Korean Journal of Hepatology Elsewhere : The use of vaptan in hyponatremic patients with Liver cirrhosis

( Won Hyeok Choe ) 대한간학회 2011 Clinical and Molecular Hepatology(대한간학회지) Vol.17 No.4

Editorial : Do cirrhotic patients with a high MELD score benefit from TIPS?

( Won Hyeok Choe ) 대한간학회 2014 Clinical and Molecular Hepatology(대한간학회지) Vol.20 No.1

PE-022: HBsAg Level Change in Chronic Hepatitis B Patients Who Achieved Virological Response with Oral Antiviral Agents

( Won Hyeok Choe ),( So Young Kwon ),( Byung-chul Yoo ),( Jeong Han Kim ) 대한간학회 2016 춘·추계 학술대회 (KASL) Vol.2016 No.1

Aims: Oral antiviral agents are main stay of chronic hepatitis B (CHB) treatment and most patients can achieve virological response (VR, undetectable HBV DNA). However, final end point is HBsAg loss and seroconversion. We aimed to evaluate HBsAg level change in CHB patients who achived VR with oral antiviral agents. Methods: This is a retrospective study and the treatment naive CHB patients who achived VR with oral antiviral agents in Konkuk university hospital more than 3 years were enrolled. HBsAg level change was analyzed with Friedman test. Results: Total 105 patients were included in this study. Median age was 51 years and 33 patients were male (31.4%). HBeAg positive patients were 60 (57.1%), cirrhosis patients were 45 (42.9%) and hepatocellular carcinoma patients were 15 (14.3%). Used agents were lamivudine (LMV) in 45 patients (42.9%), entecavir (ETV) in 45 patients (42.9%) and tenofovir (TDF) in 15 patients (14.3%). During 3 years teatment, HBsAg level was reduced from mean 3.24 (log10 IU/mL) to 3.11 (log10 IU/mL) significantly (p=0.005). In subanalysis according to HBeAg status and agents, only ETV treated patients showed significant HBsAg reduction (p=0.001). During 5 years treatment except TDF treated patients due to short duration, HBeAg negative (p<0.001), LMV treated (p=0.001), ETV treated (p=0.038) patients showed significant HBsAg reduction. Conclusions: Successful oral antiviral agents treatment can lead to HBsAg reduction in CHB patients. More powerful agent may reduce HBsAg more rapidly especially in HBeAg negative patients.

Evolution of hepatitis B virus mutation during entecavir rescue therapy in patients with antiviral resistance to lamivudine and adefovir.

Choe, Won Hyeok,Hong, Sun Pyo,Kim, Byung Kook,Ko, Soon Young,Jung, Young Kul,Kim, Ji Hoon,Yeon, Jong Eun,Byun, Kwan Soo,Kim, Kyun-Hwan,Ji, Seung Il,Kim, Soo-Ok,Lee, Chang Hong,Kwon, So Young International Medical Press 2009 ANTIVIRAL THERAPY Vol.14 No.7

<P>BACKGROUND: The efficacy of entecavir (ETV) monotherapy in treatment-experienced patients with chronic hepatitis B (CHB) is debatable. METHODS: A total of 22 hepatitis B e antigen (HBeAg)-positive CHB patients who had shown viral breakthrough or suboptimal response with lamivudine (3TC) and adefovir disoproxil (ADV) therapy were treated with 1.0 mg of ETV. Clinical and virological parameters were monitored every 3 months. Restriction fragment mass polymorphism assays were used to detect antiviral resistance. RESULTS: During 3TC and ADV therapy, 11 patients had rtM204V/I mutations, 2 had rtA181V/T or rtN236T, 7 had both and 2 had no 3TC- or ADV-related mutations. After switching to ETV monotherapy, the median change in serum hepatitis B virus (HBV) DNA level was -2.1 log(10) copies/ml. Virological response (HBV DNA<300 copies/ml) was achieved in 1 of 18 patients with pre-existing rt204 mutations, whereas it was achieved in all 4 patients without pre-existing rt204 mutations regardless of the presence of rt181 or rt236 mutations. Changes in mutational patterns during ETV therapy showed that rt204 mutations persisted or re-emerged. Relative abundances of rtM204V/I mutations in total viral populations gradually increased under ETV rescue, whereas those with rtA181V/T and rtN236T mutations decreased. ETV resistance mutations (rtL180M+rtT184I/L[rtS202G]+rtM204V) were detected in five patients with pre-existing rt204 mutations. CONCLUSIONS: ETV monotherapy resulted in a limited virological response in patients who had previously failed 3TC and ADV rescue therapy. The limited efficacy might be associated with residual or reselected rtM204V/I mutations leading to ETV resistance. Combination treatment including potent antiviral agents should be recommended for patients with pre-existing rtM204V/I mutations.</P>

만성 간질환 치료의 최신 지견 : 문맥압 항진증 치료의 최신지견

최원혁 ( Won Hyeok Choe ) 대한내과학회 2009 대한내과학회지 Vol.77 No.3

Portal hypertension is responsible for most of the complications associated with liver cirrhosis, including variceal hemorrhage, ascites, and hepatic encephalopathy. It has become clear that a decrease in portal pressure can prevent or manage these serious complications. Until now, the pharmacotherapy of portal hypertension has focused on agents that reduce splanchnic blood flow, such as non-selective beta blockers and splanchnic vasoconstrictors. However, recent advances in the knowledge of the pathophysiology of portal hypertension have directed future treatment towards modulating the increased intrahepatic vascular resistance, in addition to managing the splanchnic circulation. Consequently, agents that modulate either the hyperdynamic circulation or angiogenesis are new therapeutic targets for managing portal hypertension. Several have been developed or are under investigation. To incorporate these pharmacologic approaches into clinical practice, data on patient-oriented outcomes are needed. (Korean J Med 77:282-289, 2009)