TY  - JOUR
A1  - Heidrich, Benjamin
A1  - Cordes, Hans-Jörg
A1  - Klinker, Hartwig
A1  - Möller, Bernd
A1  - Naumann, Uwe
A1  - Rössle, Martin
A1  - Kraus, Michael R.
A1  - Böker, Klaus H.
A1  - Roggel, Christoph
A1  - Schuchmann, Marcus
A1  - Stoehr, Albrecht
A1  - Trein, Andreas
A1  - Hardtke, Svenja
A1  - Gonnermann, Andrea
A1  - Koch, Armin
A1  - Wedemeyer, Heiner
A1  - Manns, Michael P.
A1  - Cornberg, Markus
T1  - Treatment Extension of Pegylated Interferon Alpha and Ribavirin Does Not Improve SVR in Patients with Genotypes 2/3 without Rapid Virological Response (OPTEX Trial): A Prospective, Randomized, Two-Arm, Multicentre Phase IV Clinical Trial
JF  - PLoS ONE
N2  - Although sofosbuvir has been approved for patients with genotypes 2/3 (G2/3), many parts of the world still consider pegylated Interferon alpha (P) and ribavirin (R) as standard of care for G2/3. Patients with rapid virological response (RVR) show response rates >80%. However, SVR (sustained virological response) in non-RVR patients is not satisfactory. Longer treatment duration may be required but evidence from prospective trials are lacking. A total of 1006 chronic HCV genotype 2/3 patients treated with P/R were recruited into a German HepNet multicenter screening registry. Of those, only 226 patients were still HCV RNA positive at week 4 (non-RVR). Non-RVR patients with ongoing response after 24 weeks P-2b/R qualified for OPTEX, a randomized trial investigating treatment extension of additional 24 weeks (total 48 weeks, Group A) or additional 12 weeks (total 36 weeks, group B) of 1.5 \(\mu\)g/kg P-2b and 800-1400 mg R. Due to the low number of patients without RVR, the number of 150 anticipated study patients was not met and only 99 non-RVR patients (n=50 Group A, n=49 Group B) could be enrolled into the OPTEX trial. Baseline factors did not differ between groups. Sixteen patients had G2 and 83 patients G3. Based on the ITT (intention-to-treat) analysis, 68% [55%; 81%] in Group A and 57% [43%; 71%] in Group B achieved SVR (p=0.31). The primary endpoint of better SVR rates in Group A compared to a historical control group (SVR 70%) was not met. In conclusion, approximately 23% of G2/3 patients did not achieve RVR in a real world setting. However, subsequent recruitment in a treatment-extension study was difficult. Prolonged therapy beyond 24 weeks did not result in higher SVR compared to a historical control group.
KW  - chronic hepatitis C
KW  - peginterferon alpha-2b
KW  - infection
KW  - sofosbuvir
KW  - therapy
KW  - HCV genotype 2
Y1  - 2015
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-151811
VL  - 10
IS  - 6
ER  - 
TY  - JOUR
A1  - Schlevogt, Bernhard
A1  - Boeker, Klaus H. W.
A1  - Mauss, Stefan
A1  - Klinker, Hartwig
A1  - Heyne, Renate
A1  - Link, Ralph
A1  - Simon, Karl-Georg
A1  - Sarrazin, Christoph
A1  - Serfert, Yvonne
A1  - Manns, Michael P.
A1  - Wedemeyer, Heiner
T1  - Weight gain after interferon-free treatment of chronic hepatitis C — results from the German Hepatitis C-Registry (DHC-R)
JF  - Biomedicines
N2  - Chronic hepatitis C can be treated very effectively with direct-acting antivirals (DAA) with only minor side effects compared to an interferon-containing treatment regimen. The significance of metabolic comorbidities after HCV cure is not well defined. This study aims to investigate short- and long-term weight change of patients receiving interferon-free antiviral treatment for chronic hepatitis C. The German Hepatitis C-registry (DHC-R) is a national multicenter real-world cohort. A total of 5111 patients were followed prospectively after DAA treatment for up to 3 years. Weight change compared to baseline was analyzed at end of treatment and at years 1, 2, and 3 after completion of antiviral therapy. Regression analysis was performed to identify baseline predictors for weight change. While there was no relevant mean weight change (−0.2 kg, SD 4.3 kg) at the end of antiviral treatment, weight started to increase during long-term follow-up reaching +1.7 kg (SD 8.0 kg, p < 0.001) compared to baseline at 3 years (follow-up year 3, FU3) after completion of antiviral therapy. 48%, 31%, and 22% of patients had a weight gain greater than 1, 3, and 5 kg at FU3, respectively. During follow-up, a body mass index (BMI) <30 proved to be the only consistent predictor for weight gain. DAA treatment is followed by a substantial weight gain (+3 kg or more) in one-third of the patients during long-term follow-up. Non-obese patients seemed to be most vulnerable to weight gain. The body compartment involved in weight gain as well as the mechanism of weight gain remain to be elucidated.
KW  - chronic hepatitis C
KW  - direct-acting antivirals
KW  - interferon-free
KW  - HCV cure
KW  - weight gain
KW  - German Hepatitis C-Registry
Y1  - 2021
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-248476
SN  - 2227-9059
VL  - 9
IS  - 10
ER  -