HBV抑制可改善患者报告的长期预后

StephenW

HBV suppression improves long-term patient-reported outcomes

Younossi ZM, et al. Clin Gastroenterol Hepatol. 2018;doi:10.1016/j.cgh.2018.09.041.
September 28, 2018

Hepatitis B viral suppression had a sustainable, positive impact on patient-reported outcomes, according to results of a long-term follow-up study.

“HBV infection and its complications are responsible for a tremendous clinical burden related to cirrhosis and hepatocellular carcinoma,” Zobair M. Younossi, MD, and colleagues wrote. “In contrast, long-term HBV suppression can improve hepatic fibrosis and clinical outcomes. In addition to the clinical burden, HBV can negatively impact patient-reported outcomes (PROs) while viral suppression leads to their improvement.

Younossi and colleagues enrolled 229 patients with HBV in the registry, 87.8% of whom were on standard-of-care oral antiviral therapy at baseline. Thirteen patients had detectable HBV viremia at baseline and 15 additional patients developed detectable viremia at least once during follow-up.

PROs were similar or higher than general population norms except for the “Worry” domain of the Chronic Liver Disease Questionnaire (P < .01) and the “Presenteeism” and “Activity” domains of the Work Productivity and Activity Impairment tool (P < .0001).

PRO scores were similar between Asian and non-Asian patients and between patients from different countries. Men had higher “Physical Functioning” scores compared with women (P = .03). Patients who discontinued oral antiviral therapy were more frequently viremic (P < .0001) and had lower scores in the “Emotional” domain of the Chronic Liver Disease Questionnaire (P = .02) at baseline.

By week 48, the researchers observed significant improvements in the “General Health” and “Role Emotional” domains of the Short Form-36 PRO tool (P < .05).

“Patient-reported outcomes are essential for understanding the comprehensive impact of HBV infection on patients’ health. Additionally, PROs are important when assessing the effect of any treatment regimen because PROs are tightly linked to adherence which is critically important for long-term suppression of HBV,” Younossi and colleagues wrote. “These PRO data, coupled with clinical outcomes, should inform patients, providers, and payers about the benefit of long-term viral suppression in patients with chronic HBV infection.” – by Talitha Bennett

Disclosure: Younossi reports he is a consultant to or has received research funds from AbbVie, Bristol-Myers Squibb, Gilead, GlaxoSmithKline, Intercept, NovoNordisk and Shinogi. Please see the full study for the other authors’ relevant financial disclosures.

StephenW

HBV抑制可改善患者报告的长期预后

Younossi ZM，et al。 Clin Gastroenterol Hepatol。 2018; DOI：10.1016 / j.cgh.2018.09.041。
2018年9月28日

根据一项长期随访研究的结果，乙型肝炎病毒抑制对患者报告的结果具有可持续的积极影响。

“HBV感染及其并发症是造成与肝硬化和肝细胞癌相关的巨大临床负担的原因，”Zobair M. Younossi，MD及其同事写道。 “相比之下，长期HBV抑制可以改善肝纤维化和临床结果。除了临床负担之外，HBV还会对患者报告的结果（PROs）产生负面影响，而病毒抑制会导致其改善。

Younossi及其同事在登记处登记了229例HBV患者，其中87.8％的患者在基线时接受了标准治疗的口服抗病毒治疗。 13名患者在基线时有可检测到的HBV病毒血症，另有15名患者在随访期间至少发生一次可检测到的病毒血症。

除了慢性肝病问卷的“忧虑”域（P <.01）和工作生产率和活动障碍工具的“出勤”和“活动”域之外，PRO与一般人群规范相似或更高（P <。 0001）。

亚洲和非亚洲患者以及来自不同国家的患者之间的PRO评分相似。与女性相比，男性的“身体功能”得分更高（P = .03）。停用口服抗病毒治疗的患者更频繁地发生病毒血症（P <.0001），并且在基线时慢性肝病问卷（P = .02）的“情绪”领域得分较低。

到第48周，研究人员观察到Short Form-36 PRO工具的“一般健康”和“角色情感”领域的显着改善（P <.05）。

“患者报告的结果对于了解HBV感染对患者健康的综合影响至关重要。此外，PROs在评估任何治疗方案的效果时都很重要，因为PROs与坚持紧密相关，这对于长期抑制HBV至关重要，“Younossi及其同事写道。 “这些PRO数据与临床结果相结合，应该告知患者，提供者和付款人慢性HBV感染患者长期病毒抑制的益处。” - 作者：Talitha Bennett

披露：Younossi报道他是AbbVie，Bristol-Myers Squibb，Gilead，GlaxoSmithKline，Intercept，NovoNordisk和Shinogi的顾问或已获得研究经费。有关其他作者的相关财务披露，请参阅完整的研究。