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Martin-Cardona A, Horta D, Florez-Diez P, Vela M, Mesonero F, Ramos Belinchón C, García MJ, Masnou H, de la Peña-Negro L, Suarez Ferrer C, Casanova MJ, Durán MO, Peña E, Calvet X, Fernández-Prada SJ, González-Muñoza C, Piqueras M, Rodríguez-Lago I, Sainz E, Bas-Cutrina F, Mancediño Marcos N, Ojeda A, Orts B, Sicilia B, García AC, Domènech E, Esteve M. Safety and effectiveness of direct-acting antiviral drugs in the treatment of hepatitis C in patients with inflammatory bowel disease. Dig Liver Dis 2024; 56:468-476. [PMID: 37770282 DOI: 10.1016/j.dld.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 08/22/2023] [Accepted: 09/04/2023] [Indexed: 09/30/2023]
Abstract
BACKGROUND AND AIMS Hepatitis C virus (HCV) management in Inflammatory Bowel Disease (IBD) is uncertain. The ECCO guidelines 2021 recommended HCV treatment but warn about the risk of IBD reactivation. We aimed to evaluate 1) the effectiveness and safety of direct-acting antivirals (DAAs) in IBD; 2) the interaction of DAAs with IBD drugs. METHODS Multicentre study of IBD patients and HCV treated with DAAs. Variables related to liver diseases and IBD, as well as adverse events (AEs) and drug interactions, were recorded. McNemar's test was used to assess differences in the proportion of active IBD during the study period. RESULTS We included 79 patients with IBD and HCV treated with DAAs from 25,998 IBD patients of the ENEIDA registry. Thirty-one (39.2 %) received immunomodulators/biologics. There were no significant differences in the percentage of active IBD at the beginning (n = 11, 13.9 %) or at the 12-week follow-up after DAAs (n = 15, 19 %) (p = 0.424). Sustained viral response occurred in 96.2 % (n = 76). A total of 8 (10.1 %) AEs occurred and these were unrelated to activity, type of IBD, liver fibrosis, immunosuppressants/biologics, and DAAs. CONCLUSIONS We demonstrate a high efficacy and safety of DAAs in patients with IBD and HCV irrespective of activity and treatment of IBD.
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Affiliation(s)
- A Martin-Cardona
- Digestive Diseases Department, Hospital Universitari Mútua Terrassa, Terrassa, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
| | - D Horta
- Digestive Diseases Department, Hospital Universitari Mútua Terrassa, Terrassa, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
| | - P Florez-Diez
- Digestive Diseases Department, H.U. Central de Asturias, Oviedo, Spain
| | - M Vela
- Digestive Diseases Department, H. Nuestra Sra. de la Candelaria, Santa Cruz de Tenerife, Spain
| | - F Mesonero
- Digestive Diseases Department, H. Ramón y Cajal, Madrid, Spain
| | | | - M J García
- Gastroenterology and Hepatology Department, H. U. Marques de Valdecilla, IDIVAL, Santander, Spain
| | - H Masnou
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain; Digestive Diseases Department, H.U. Germans Trias i Pujol, Badalona, Spain
| | - L de la Peña-Negro
- Digestive Diseases Department, H.U. Bellvitge, Hospitalet de Llobregat, Spain
| | | | - M J Casanova
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain; Digestive Diseases Department, Hospital Universitario de La Princesa-Instituto de Investigación Sanitaria Princesa (IIS-Princesa), Madrid, Spain
| | - M Ortiz Durán
- Digestive Diseases Department, H.U. Infanta Cristina, Madrid, Spain
| | - E Peña
- Digestive Diseases Department, Hospital Royo Villanova, Zaragoza, Spain
| | - X Calvet
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain; Digestive Diseases Department, Corporació Sanitària Universitària Parc Taulí, Sabadell, Spain
| | | | - C González-Muñoza
- Digestive Diseases Department, H. de la Santa Creu i Sant Pau, Barcelona, Spain
| | - M Piqueras
- Digestive Diseases Department, Consorci Sanitari de Terrassa, Terrassa, Spain
| | - I Rodríguez-Lago
- Digestive Diseases Department, Hospital Universitario de Galdakao and Biocruces Bizkaia Health Research Institute- Galdakao, Galdakao, Spain
| | - E Sainz
- Digestive Diseases Department, Althaia Xarxa Assistencial Universitària de Manresa, Manresa, Spain
| | - F Bas-Cutrina
- Digestive Diseases Department, H. General de Granollers, Granollers, Spain
| | - N Mancediño Marcos
- Digestive Diseases Department, Hospital Universitario Infanta Sofía, Madrid, Spain
| | - A Ojeda
- Digestive Diseases Department, H.G.U. Elche, Elche, Spain
| | - B Orts
- Clinical Pharmacology Department, Hospital General Universitario de Alicante, Alicante, Spain
| | - B Sicilia
- Digestive Diseases Department, Hospital Universitario de Burgos, Burgos, Spain
| | - A Castaño García
- Digestive Diseases Department, H.U. Central de Asturias, Oviedo, Spain
| | - E Domènech
- Digestive Diseases Department, H.U. Germans Trias i Pujol, Badalona, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain
| | - M Esteve
- Digestive Diseases Department, Hospital Universitari Mútua Terrassa, Terrassa, Spain; Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Madrid, Spain.
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Abstract
Subjective tests based on information gathered using 'discomfort questionnaires' have been used widely in ergonomics. In this study, we used a similar method to examine the discomfort associated with the footwear worn in tennis matches. A sample of 146 tennis players from a population of approximately 4000 completed the questionnaire. We performed a descriptive analysis of the study variables. The associations between discomfort and pain and between discomfort and design errors were evaluated using cross-tabulation and chi-squared tests. We found that 9% of players considered their footwear to be uncomfortable, 23% considered it to be acceptable and 68% regarded it as comfortable. Six design errors were identified and five body areas were reported as experiencing discomfort due to the footwear. Factor analysis identified four factors related to discomfort and six design errors. Subsequent correlation analysis identified several relationships among these factors. There was a strong correlation (r = 0.187, P = 0.022) between plantar discomfort and incorrect arch support.
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Affiliation(s)
- S Llana
- Facultad de Ciencias de la Actividad Física y del Deporte, Universidad de Valencia, Valencia, Spain.
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Abstract
Idiopathic chondrolysis of the hip is characterized by the destruction of the articular cartilage due to an unknown cause, principally affecting women during adolescence and producing premature degeneration of the hip. Twelve cases (11 patients) were reviewed at our hospital, with an average follow-up period of 13.2 years, during which a clinical and radiologic study was performed. Despite the treatment implemented, idiopathic chondrolysis of the hip causes progressive degeneration of the joint with the appearance of almost constant pain, stiffness, and anomalous positions. Radiologic studies show concentric narrowing of the articular space, decrease in the width of the femoral head and neck, and shortening of the affected member due to alteration in the growth physis of the upper extremity of the femur.
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Affiliation(s)
- A del Couz García
- Department of Orthopedic Surgery, Hospital Central de Asturias, Oviedo, Spain
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Abstract
A new methodology of biomechanical analysis of materials for shoe inserts is presented. This methodology is based on the determination of the loads applied to the materials in real situations and its simulation by means of a dynamic testing machine. Both the rigidity and the energy-absorbing characteristics of the materials are investigated as a function of frequency. This methodology is applied to the study of several commercially available viscoelastic materials intended for shoe inserts in the treatment and prevention of degenerative joint diseases. The influence of thickness is investigated as well as the frequency-dependent behavior of the materials studied. Significant differences between materials and different behavior as a function of thickness and frequency were found. Poron materials were found to have the lowest rigidity, good for adequate pressure distribution, while Noene showed the highest energy absorption. A careful selection of the thickness of Sorbothane was found to be necessary for avoiding flattening of the material.
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Affiliation(s)
- A C García
- Institute of Biomechanics of Valencia, València Parc Tecnològic, Paterna, Spain
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