Sustained virologic response (SVR) obtained with interferon (IFN) or with direct-acting antivirals (DAAs) is commonly followed by response of hepatitis C virus (HCV)-associated mixed cryoglobulinemia vasculitis (MCV), but relapse of MCV despite SVR has been reported in several patients after DAAs and rarely after IFN. Since relapses could have been overlooked in studies with IFN, we retrospectively compared the outcomes of MCV in SVR patients treated with DAAs (n=70) or IFN (n=39) followed-up, respectively, for 30.5 (range 11-51) or 48 months. Groups were comparable for demographics and clinics and response rates of MCV were similar (92% and 86%); however, DAA-treated patients less efficiently reduced cryoglobulins (p=0.006) and circulating B-cell clones (p=0.004), and had more frequently relapses of MCV (18% vs. 3%, p=0.028) and need for rituximab therapy (p=0.01). Although largely inferior on an intention-to-treat basis, IFN may be superior to DAAs on clinico-immunologic outcomes possibly owing to its antiproliferative activity.
Clinico-immunologic outcomes of HCV-cured cryoglobulinemia: lower relapse rate with interferon-based than interferon-free therapy / Colantuono, Stefania; Marrapodi, Ramona; Del Padre, Martina; Collalti, Giulia; Garzi, Giulia; De Santis, Adriano; Fiorilli, Massimo; Basili, Stefania; Visentini, Marcella; Casato, Milvia. - In: LIVER INTERNATIONAL. - ISSN 1478-3223. - (2020). [10.1111/liv.14698]
Clinico-immunologic outcomes of HCV-cured cryoglobulinemia: lower relapse rate with interferon-based than interferon-free therapy
Colantuono, Stefania;Marrapodi, Ramona;Del Padre, Martina;Collalti, Giulia;Garzi, Giulia;De Santis, Adriano;Fiorilli, Massimo;Basili, Stefania;Visentini, Marcella;Casato, Milvia
2020
Abstract
Sustained virologic response (SVR) obtained with interferon (IFN) or with direct-acting antivirals (DAAs) is commonly followed by response of hepatitis C virus (HCV)-associated mixed cryoglobulinemia vasculitis (MCV), but relapse of MCV despite SVR has been reported in several patients after DAAs and rarely after IFN. Since relapses could have been overlooked in studies with IFN, we retrospectively compared the outcomes of MCV in SVR patients treated with DAAs (n=70) or IFN (n=39) followed-up, respectively, for 30.5 (range 11-51) or 48 months. Groups were comparable for demographics and clinics and response rates of MCV were similar (92% and 86%); however, DAA-treated patients less efficiently reduced cryoglobulins (p=0.006) and circulating B-cell clones (p=0.004), and had more frequently relapses of MCV (18% vs. 3%, p=0.028) and need for rituximab therapy (p=0.01). Although largely inferior on an intention-to-treat basis, IFN may be superior to DAAs on clinico-immunologic outcomes possibly owing to its antiproliferative activity.File | Dimensione | Formato | |
---|---|---|---|
Colantuono_Clinico-immunologic-outcomes_2020.pdf
solo gestori archivio
Tipologia:
Documento in Post-print (versione successiva alla peer review e accettata per la pubblicazione)
Licenza:
Tutti i diritti riservati (All rights reserved)
Dimensione
6.13 MB
Formato
Adobe PDF
|
6.13 MB | Adobe PDF | Contatta l'autore |
I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.