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Record W2599422016 · doi:10.1093/jcag/gwy008.177

A176 SOFOSBUVIR/VELPATASVIR-BASED REGIMENS ARE ASSOCIATED WITH EXCELLENT EFFICACY AND A SIGNIFICANT IMPROVEMENT OF PATIENTS-REPORTED OUTCOMES ACROSS PATIENT POPULATIONS: FROM NON-CIRRHOTICS TO COMPENSATED CIRRHOTICS TO DECOMPENSATED CIRRHOTICS

2018· article· en· W2599422016 on OpenAlexaff
Zobair M. Younossi, Maria Stepanova, Jordan J. Feld, Stefan Zeuzem, Mark Sulkowski, Graham R. Foster, Alessandra Mangia, Michael Charlton, Jacqueline G. O’Leary, Michael P. Curry, Fatema Nader, Linda Henry, Sharon Hunt

Bibliographic record

VenueJournal of the Canadian Association of Gastroenterology · 2018
Typearticle
Languageen
FieldMedicine
TopicHepatitis C virus research
Canadian institutionsUniversity of TorontoUniversity Health Network
Fundersnot available
KeywordsMedicineCirrhosisInternal medicineGastroenterologySofosbuvirRibavirinChronic hepatitisImmunologyVirus

Abstract

fetched live from OpenAlex

Our aim was to assess the impact SOF/VEL±ribavirin (RBV) on patient-reported outcomes (PROs) in HCV patients with and without decompensated cirrhosis. Four PRO questionnaires (SF-36, CLDQ-HCV, FACIT-F, WPAI:HCV) were collected in 4 phase 3 trials of SOF/VEL (ASTRAL-1,2, 3 and 4). The baseline PROs and treatment-emergent changes in PROs were compared among 3 groups (no cirrhosis, compensated cirrhosis, decompensated cirrhosis) while receiving +/- RBV-containing regimens. 1,701 patients received SOF/VEL or SOF/VEL+RBV or SOF+RBV for 12 or 24 weeks: 1,112 without cirrhosis, 338 with compensated cirrhosis, 251 with decomp cirrhosis; 488 received RBV-containing regimens [SOF+RBV (N=401) and SOF/VEL+RBV (N=87)] and 1,213 received RBV-free SOF/VEL. Decomp cirrhotics were older, more commonly male and less treatment-naive, and had more pre-treatment depression, anxiety, type 2 diabetes, fatigue and insomnia (all p<0.002). SVR-12 was 84.7% (SOF/VEL in decomp cirrhosis, all GTs), 98.5% (SOF/VEL non-cirrhotics, all GTs), 66.3% (SOF+RBV in GT3 cirrhotics), 94.7% (SOF+RBV in non-GT3 cirrhotics) and 94.3% (SOF/VEL+RBV in decomp cirrhotics, all GTs). Cirrhotic patients had significantly lower baseline PRO scores (up to -33.5 points on a universal 0–100 PRO scale in patients with decomp cirrhosis in comparison to patients without cirrhosis; p<0.05 for all but three PRO domains). By the end of treatment with RBV+ regimens, changes in PROs were similar across 3 groups (all p>0.01) and included moderate improvements in some PROs (up to +11.8, p<0.05 for 8/26 PRO scores) and moderate decrements in others (up to -7.1, p<0.05 for 6 mental health-related PRO scores). After treatment cessation, improvements from baseline (up to +12.6 points by post-treatment week 4, up to +14.2 by week 12, +17.1 by week 24) were again similar in all patients regardless of cirrhosis status (all p>0.01). By SVR-12 follow-up, PRO improvements were sustained in patients with decompensated cirrhosis: average across PROs +5.8 vs. +4.1 in compensated cirrhosis or no cirrhosis, p<0.05 for 7/26 PROs. In multivariate analysis, compensated cirrhosis was associated with additional +2.3 to +5.0 points improvement of treatment-emergent PRO (all p<0.05), decompensated cirrhosis – with +5.5 to 9.1 points (all p<0.002) in SOF/VEL regimen. HCV patients with decompensated cirrhosis experience the greatest improvement of their PRO scores during treatment with SOF/VEL regimen. SVR is associated with significant improvements in PROs, especially in patients with decompensated cirrhosis. Gilead Sciences, Inc.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.001
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.002
Threshold uncertainty score0.007

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0010.001
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0020.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.027
GPT teacher head0.293
Teacher spread0.266 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations0
Published2018
Admission routes1
Has abstractyes

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Same venueJournal of the Canadian Association of Gastroenterology→Same topicHepatitis C virus research→French-language works237,207→