1Center for Liver Diseases, Department of Medicine, Inova Fairfax Hospital, Falls Church, VA, United States; Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, United States. Electronic address: firstname.lastname@example.org.
2Center for Liver Diseases, Department of Medicine, Inova Fairfax Hospital, Falls Church, VA, United States; Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, VA, United States.
3Johann Wolfgang Goethe University, Frankfurt, Germany.
4Royal Free Hospital, London, England.
5Hospital Universitario Val d'Hebron, Barcelona, Spain.
6Hôpital Henri Mondor, Université Paris-Est, Créteil, France.
7Academic Medical Center, Amsterdam, the Netherlands.
8Karolinska Institutet, Karolinska University Hospital, Huddinge, Stockholm, Sweden.
9Center for Liver Diseases, Department of Medicine, Inova Fairfax Hospital, Falls Church, VA, United States.
BACKGROUND AND AIM:
Interferon (IFN) negatively impacts patients' well-being and patient-reported outcomes (PROs). Our aim was to assess PROs during treatment with an IFN-free regimen [sofosbuvir (SOF)+ribavirin (RBV)].
Four PRO questionnaires [Short Form-36 (SF-36), Chronic Liver Disease Questionnaire-HCV (CLDQ-HCV), Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), Work Productivity and Activity Index: Specific Health Problem (WPAI:SHP)] were administered at baseline, end-of-treatment and post-treatment to 334 HCV genotype 2 and 3 patients (naïve or treatment-experienced) enrolled in the VALENCE study. Of these, 250 genotype 3 patients were treated for 24 weeks while 73 genotype 2 and 11 genotype 3 patients received 12 weeks of treatment.
Baseline PRO scores were similar between the two arms of the study. Throughout and after treatment, patients receiving 12 or 24 weeks had similar FACIT-F, CLDQ-HCV, SF-36 and WPAI:SHP scores (all p>0.05). Compared to their own baseline scores, patients receiving SOF+RBV experienced modest declines in some aspects of SF-36, CLDQ-HCV, fatigue and WPAI:SHP scores (p=0.04 to <0.0001). By follow-up week 12, all PRO scores returned to the pre-treatment levels (p>0.05). In patients achieving SVR-12 (regardless of the regimen), significant improvements were noted in general health (p=0.0004), CLDQ-HCV (p<0.0001), fatigue (p=0.005), emotional well-being (p<0.0001) and physical component summary score of SF-36 (p=0.0022). In multivariate analysis, baseline depression, fatigue, insomnia, cirrhosis and treatment-related adverse events were the most consistent predictors of PRO impairment (all p<0.05).
PROs are minimally impacted by SOF+RBV regimens. An additional 12 weeks of treatment does not substantially add to the PRO burden.