@article{6a77c9a372154c61a5f0128305e87705,
title = "Impact of Sofosbuvir-Based Direct-Acting Antivirals on Renal Function in Chronic Hepatitis C Patients With Impaired Renal Function: A Large Cohort Study From the Nationwide HCV Registry Program (TACR)",
abstract = "Background & Aims: Sofosbuvir is approved for chronic hepatitis C (CHC) patients with severe chronic kidney disease (CKD). The impact of sofosbuvir-based therapy on renal function augmentation on a real-world nationwide basis is elusive. Methods: The 12,995 CHC patients treated with sofosbuvir-based (n = 6802) or non–sofosbuvir-based (n = 6193) regimens were retrieved from the Taiwan nationwide real-world HCV Registry Program. Serial estimated glomerular filtration rate (eGFR) levels were measured at baseline, end of treatment (EOT), and end of follow-up (EOF) (3 months after EOT). Results: The eGFR decreased from baseline (91.4 mL/min/1.73 m2) to EOT (88.4 mL/min/1.73 m2; P <.001) and substantially recovered at EOF (88.8 mL/min/1.73 m2) but did not return to pretreatment levels (P <.001). Notably, a significant decrease in eGFR was observed only in patients with baseline eGFR ≥90 mL/min/1.73 m2 (from 112.9 to 106.4 mL/min/1.73 m2; P <.001). In contrast, eGFR increased progressively in patients whose baseline eGFR was <90 mL/min/1.73 m2 (from 70.0 to 71.5 mL/min/1.73 m2; P <.001), and this increase was generalized across different stages of CKD. The trend of eGFR amelioration was consistent irrespective of sofosbuvir usage. Multivariate adjusted analysis demonstrated that baseline eGFR >90 mL/min/1.73 m2 was the only factor independently associated with significant slope coefficient differences of eGFR (–1.98 mL/min/1.73 m2; 95% confidence interval, –2.24 to –1.72; P <.001). The use of sofosbuvir was not an independent factor associated with eGFR change. Conclusions: Both sofosbuvir and non–sofosbuvir-based regimens restored renal function in CHC patients with CKD, especially in those with significant renal function impairment.",
keywords = "CKD, DAA, eGFR, Real World, Sofosbuvir",
author = "Huang, {Chung Feng} and Tseng, {Kuo Chih} and Cheng, {Pin Nan} and Hung, {Chao Hung} and Lo, {Ching Chu} and Peng, {Cheng Yuan} and Bair, {Ming Jong} and Yeh, {Ming Lun} and Chen, {Chien Hung} and Lee, {Pei Lun} and Lin, {Chun Yen} and Kuo, {Hsing Tao} and Chen, {Chun Ting} and Yang, {Chi Chieh} and Huang, {Jee Fu} and Tai, {Chi Ming} and Hu, {Jui Ting} and Lin, {Chih Lang} and Su, {Wei Wen} and Tsai, {Wei Lun} and Huang, {Yi Hsiang} and Cheng, {Chien Yu} and Lin, {Chih Lin} and Wang, {Chia Chi} and Yang, {Sheng Shun} and Mo, {Lein Ray} and Chen, {Guei Ying} and Chang, {Chun Chao} and Wang, {Szu Jen} and Huang, {Chia Sheng} and Hsieh, {Tsai Yuan} and Lin, {Chih Wen} and Lee, {Tzong Hsi} and Chong, {Lee Won} and Huang, {Chien Wei} and Chang, {Shiuh Nan} and Tsai, {Ming Chang} and Hsu, {Shih Jer} and Kao, {Jia Horng} and Liu, {Chun Jen} and Liu, {Chen Hua} and Lin, {Han Chieh} and Lee, {Mei Hsuan} and Tsai, {Pei Chien} and Dai, {Chia Yen} and Chuang, {Wan Long} and Chen, {Chi Yi} and Yu, {Ming Lung}",
note = "Funding Information: The authors thank the Taiwan Association for the Study of the Liver (TASL), the TASL Foundation, and Taiwan Liver Research Foundation for grant support and the TACR study group for data collection. They also thank the Center for Medical Informatics and Statistics of Kaohsiung Medical University for providing administrative and funding support. Chung-Feng Huang (Investigation: Equal; Writing ? original draft: Lead), Kuo-Chih Tseng (Investigation: Equal), Pin-Nan Cheng (Investigation: Equal), Chao-Hung Hung (Investigation: Equal), Ching-Chu Lo (Investigation: Equal), Cheng-Yuan Peng (Investigation: Equal), Ming-Jong Bair (Investigation: Equal), Ming-Lun Yeh (Investigation: Equal), Chien-Hung Chen (Investigation: Equal), Pei-Lun Lee (Investigation: Equal), Chun-Yen Lin (Investigation: Equal), Hsing-Tao Kuo (Investigation: Equal), Chun-Ting Chen (Investigation: Equal), Chi-Chieh Yang (Investigation: Equal), Jee-Fu Huang (Investigation: Equal), Chi-Ming Tai (Investigation: Equal), Jui-Ting Hu (Investigation: Equal), Chih-Lang Lin (Investigation: Equal), Wei-Wen Su (Investigation: Equal), Wei-Lun Tsai (Investigation: Equal), Yi-Hsiang Huang (Investigation: Equal), Chien-Yu Cheng (Investigation: Equal), Chih-Lin Lin (Investigation: Equal), Chia-Chi Wang (Investigation: Equal), Sheng-Shun Yang (Investigation: Equal), Lein-Ray Mo (Investigation: Equal), Guei-Ying Chen (Investigation: Equal), Chun-Chao Chang (Investigation: Equal), Szu-Jen Wang (Investigation: Equal), Chia-Sheng Huang (Investigation: Equal), Tsai-Yuan Hsieh (Investigation: Equal), Chih-Wen Lin (Investigation: Equal), Tzong-Hsi Lee (Investigation: Equal), Lee-Won Chong (Investigation: Equal), Chien-Wei Huang (Investigation: Equal), Shiuh-Nan Chang (Investigation: Equal), Ming-Chang Tsai (Investigation: Equal), Shih-Jer Hsu (Investigation: Equal), Jia-Horng Kao (Supervision: Equal), Chun-Jen Liu (Investigation: Equal), Chen-Hua Liu (Investigation: Equal), Han-Chieh Lin (Supervision: Equal), Mei-Hsuan Lee (Formal analysis: Supporting), Pei-Chien Tsai (Data curation: Equal; Formal analysis: Equal), Chia-Yen Dai (Investigation: Equal), Wan-Long Chuang (Supervision: Equal), Chi-Yi Chen (Investigation: Equal; Validation: Lead), Ming-Lung Yu (Supervision: Lead; Writing ? original draft: Equal) Funding Information: Funding Supported by grants from Kaohsiung Medical University (MOST 109-2314-B-037-044, KMU-K1110002, MOST 108-2314-B-037 -066 -MY3, KMU-TC108B06 [Center for Liquid Biopsy], KMU-TC108B07 & KMU-DK109002 [Cohort Research Center], 105KMUOR08 [Center for Cancer Research KMU Global Networking Talent Plan Grant], and KMU-TC109B05 [Center for Liquid Biopsy and Cohort Research]) and Kaohsiung Medical University Hospital (KMUH109-9R06, KMUH109-9R05, MOHW109-TDU-B-212-114006, and KMUH-IIT-109-2-05). Funding Information: Conflicts of interest These authors disclose the following: Ming-Lung Yu: research support from AbbVie, Abbott, BMS, Gilead, Merck, and Roche; consultant for AbbVie, Abbott, Ascletis, BMS, Gilead, J&J, Merck, Novartis, Pharmaessential, and Roche; and speaker for AbbVie, Abbott, Ascletis, BMS, Gilead, Merck, Pharmaessential, and Roche. Chung-Feng Huang: speaker for AbbVie, BMS, Gilead, Merck, and Roche. Chen-Hua Liu: advisory board for AbbVie, Golead Sciences, Merck Sharp & Dohme; speaker for Abbott, AbbVie, Golead Sciences, Merck Sharp & Dohme; research grant from AbbVie, Golead Sciences, and Merck Sharp & Dohme. The remaining authors disclose no conflicts. Publisher Copyright: {\textcopyright} 2022 AGA Institute",
year = "2022",
month = may,
doi = "10.1016/j.cgh.2021.07.037",
language = "English",
volume = "20",
pages = "1151--1162.e6",
journal = "Clinical Gastroenterology and Hepatology",
issn = "1542-3565",
publisher = "W.B. Saunders",
number = "5",
}