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Yaras S, Demir M, Barutcu S, Yildirim AE, Gurel S, Ucbilek E, Kurtulmus IA, Kayhan MA, Vatansever S, Adanir H, Danis N, Duman S, Turan I, Ari D, Kose S, Alkim H, Harputluoglu MM, Dilber F, Akyildiz M, Cosar AM, Durak S, Sirin G, Kefeli A, Gokcan H, Avcioglu U, Ayyildiz T, Sezgin O, Akarsu M, Dincer D, Guzelbulut F, Gunsar F, Akarca US, Idilman R. The efficacy and tolerability of glecaprevir/pibrentasvir treatment in a real-world chronic hepatitis C patients cohort. Hepatol Forum 2023; 4:92-96. [PMID: 37822314 PMCID: PMC10564251 DOI: 10.14744/hf.2023.2023.0001] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 06/02/2023] [Accepted: 06/13/2023] [Indexed: 10/13/2023]
Abstract
Background and Aim The aims of the present study were to evaluate the real-life efficacy and tolerability of glecaprevir (GLE)/pibrentasvir (PIB) in the treatment of patients with chronic hepatitis C (CHC). Materials and Methods Between May 2019 and May 2022, 686 patients with CHC, treated with GLE/PIB combination from 21 participating centers in Turkiye, were enrolled in the study. Results All patients were Caucasian, and their median age was 56 years. At the start of GLE/PIB treatment, the median serum Hepatitis C virus RNA and serum alanine amino transaminase (ALT) levels were 6.74 log10 IU/mL and 47 U/L, respectively. Fifty-three percent of the patients were infected with genotype 1b, followed by genotype 3 (17%). Diabetes was the more common concomitant disease. The sustained virological response (SVR12) was 91.4% with intent-to-treat analysis and 98.5% with per protocol analysis. The SVR12 rates were statistically significant differences between the patients who were i.v. drug users and non-user (88.0% vs. 98.8%, p=0.025). From the baseline to SVR12, the serum ALT levels and Model for End-Stage Liver Disease score were significantly improved (p<0.001 and p=0.014, respectively). No severe adverse effect was observed. Conclusion GLE/PIB is an effective and tolerable treatment in patients with CHC.
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Affiliation(s)
- Serkan Yaras
- Department of Gastroenterology, Mersin University, School of Medicine, Mersin, Turkiye
| | - Mehmet Demir
- Department of Gastroenterology, Mustafa Kemal University, School of Medicine, Hatay, Turkiye
| | - Sezgin Barutcu
- Department of Medical Sciences, Gaziantep University, School of Medicine, Gaziantep, Turkiye
| | | | - Selim Gurel
- Department of Internal Medicine, Uludag University, School of Medicine, Bursa, Turkiye
| | - Enver Ucbilek
- Department of Gastroenterology, Mersin University, School of Medicine, Mersin, Turkiye
| | | | - Meral Akdogan Kayhan
- Division of Gastroenterology, Department of Internal Medicine, Faculty of Health Sciences, Ankara City Hospital, Ankara, Turkiye
| | - Sezgin Vatansever
- Department of Gastroenterology, Katip Celebi University, Ataturk Training and Research Hospital, Izmir, Turkiye
| | - Haydar Adanir
- Department of Internal Medicine, Akdeniz University, School of Medicine, Antalya, Turkiye
| | - Nilay Danis
- Division of Gastroenterology and Hepatology, Department of Medicine, Johns Hopkins University, Baltimore, USA
| | - Serkan Duman
- Department of Gastroenterology, Toros State Hospital, Mersin, Turkiye
| | - Ilker Turan
- Department of Gastroenterology, Ege University, School of Medicine, Izmir, Turkiye
| | - Derya Ari
- Division of Gastroenterology, Department of Internal Medicine, Faculty of Health Sciences, Ankara City Hospital, Ankara, Turkiye
| | - Sukran Kose
- Department of Infectious Diseases and Clinical Microbiology, Dokuz Eylul University, School of Medicine, Izmir, Turkiye
| | - Huseyin Alkim
- Department of Gastroenterology, Sisli Etfal Training and Research Hospital, Istanbul, Turkiye
| | | | - Feyza Dilber
- Department of Gastroenterology, Marmara University, School of Medicine, Istanbul, Turkiye
| | - Murat Akyildiz
- Department of Gastroenterology, Koc University, School of Medicine, Istanbul, Turkiye
| | - Arif Mansur Cosar
- Department of Gastroenterology, Karadeniz Technical University, School of Medicine, Trabzon, Turkiye
| | - Serdar Durak
- Department of Gastroenterology, Karadeniz Technical University, School of Medicine, Trabzon, Turkiye
| | - Goktug Sirin
- Department of Gastroenterology, Kocaeli University, School of Medicine, Kocaeli, Turkiye
| | - Ayse Kefeli
- Department of Gastroenterology, Tokat Gaziosmanpasa University, School of Medicine, Tokat, Turkiye
| | - Hale Gokcan
- Department of Gastroenterology, Ankara University, School of Medicine, Ankara, Turkiye
| | - Ufuk Avcioglu
- Department of Gastroenterology, Ondokuz Mayis University, School of Medicine, Samsun, Turkiye
| | - Talat Ayyildiz
- Department of Gastroenterology, Ondokuz Mayis University, School of Medicine, Samsun, Turkiye
| | - Orhan Sezgin
- Department of Gastroenterology, Mersin University, School of Medicine, Mersin, Turkiye
| | - Mesut Akarsu
- Department of Gastroenterology, Dokuz Eylul, School of Medicine, Izmir, Turkiye
| | - Dinc Dincer
- Department of Gastroenterology, Akdeniz University, School of Medicine, Antalya, Turkiye
| | - Fatih Guzelbulut
- Departments of Gastroenterology and Pathology, Haydarpasa Numune Training and Research Hospital, Istanbul, Turkiye
| | - Fulya Gunsar
- Department of Gastroenterology, Ege University, School of Medicine, Izmir, Turkiye
| | - Ulus Salih Akarca
- Department of Gastroenterology, Ege University, School of Medicine, Izmir, Turkiye
| | - Ramazan Idilman
- Department of Gastroenterology, Ankara University, School of Medicine, Ankara, Turkiye
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Avcioglu U, Ölmez Ş, Pürnak T, Özaslan E, Altıparmak E. Evaluation of efficacy of endoscopic incision method in postoperative benign anastomotic strictures of gastrointestinal system. Arch Med Sci 2015; 11:970-7. [PMID: 26528338 PMCID: PMC4624736 DOI: 10.5114/aoms.2015.52347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2013] [Revised: 10/27/2013] [Accepted: 12/04/2013] [Indexed: 12/04/2022] Open
Abstract
INTRODUCTION Postoperative benign anastomotic strictures (POBAS) which develop after surgical resections of the gastrointestinal system (GIS) present with symptoms depending on location of the stricture. Diagnosis is confirmed by endoscopic and radiological methods. Although bougie or balloon dilatation is preferred in management, the endoscopic incision method (EIM) is also used with considerable success. In this trial, we aimed to evaluate EIM, which is one of the endoscopic dilatation techniques used in postoperative anastomotic stricture of GIS. MATERIAL AND METHODS A total of 20 POBAS patients, 12 men and 8 women, subjected to EIM intervention for strictures, were enrolled in the trial. The number of patients with upper GIS strictures was 6 (30%), while the number of cases with lower GIS strictures was 14 (70%). RESULTS Dilatation of the stricture was achieved in 15 (75%) patients with one treatment session, while more than one session of EIM was needed in 5 (25%) cases. Mean duration of follow-up of patients was 10.65 ±5.86 (0-25) months. Procedure-related complications developed in 8 patients. Among them, 7 were minor complications and improved without any treatment. In only 1 (5%) patient, perforation was observed as a major complication. Following EIM, recurrence of POBAS was observed in 5 (25%) patients. The following parameters were found to have an impact on successful outcome in EIM: presence or absence of a tortuous lumen in POBAS (p = 0.035) and length of stricture (p = 0.02), complications during the procedure (if any), and presence of single or multiple strictures. CONCLUSIONS Endoscopic incision method may be regarded as a favorable approach among first choice treatment alternatives in uncomplicated anastomotic strictures of GIS, or it may be used as an adjunctive dilatation method.
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Affiliation(s)
- Ufuk Avcioglu
- Department of Gastroenterology and Hepatology, Ankara Numune Education and Research Hospital, Ankara, Turkey
| | - Şehmus Ölmez
- Department of Gastroenterology and Hepatology, Ankara Numune Education and Research Hospital, Ankara, Turkey
| | - Tuğrul Pürnak
- Department of Gastroenterology and Hepatology, Ankara Numune Education and Research Hospital, Ankara, Turkey
| | - Ersan Özaslan
- Department of Gastroenterology and Hepatology, Ankara Numune Education and Research Hospital, Ankara, Turkey
| | - Emin Altıparmak
- Department of Gastroenterology and Hepatology, Ankara Numune Education and Research Hospital, Ankara, Turkey
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Ertek S, Cicero AF, Cesur M, Akcil M, Altuner Kayhan T, Avcioglu U, Korkmaz ME. The severity of coronary atherosclerosis in diabetic and non-diabetic metabolic syndrome patients diagnosed according to different criteria and undergoing elective angiography. Acta Diabetol 2011; 48:21-7. [PMID: 20680373 DOI: 10.1007/s00592-010-0211-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2009] [Accepted: 07/21/2010] [Indexed: 01/06/2023]
Abstract
Our aim in this study was to evaluate the relationship between metabolic syndrome (MS) as defined by different criteria and the severity of coronary lesions in a sample of diabetic and non-diabetic patients undergoing elective coronary angiography. All patients had blood and urine tests, physical examinations were performed before angiography, and finally they were classified based on three criteria (World Health Organisation-WHO, Adult Treatment Panel-ATP III and International Diabetes Federation-IDF). Eighty-eight patients were diabetic, and 96 patients were non-diabetic. Among all patients, diabetics had significantly higher Gensini scores (P < 0.001). According to WHO criteria (P = 0.005) and IDF criteria (P = 0.015) metabolic syndrome patients had higher Gensini scores, but for ATP III criteria difference was not significant. When we evaluated diabetics and non-diabetics separately, non-diabetic patients with MS had significantly higher scores with WHO definition (P = 0.015) and mildly higher but not significant values with other MS criteria (P = 0.057 for both IDF and ATP III). Neither any one of MS components nor gender revealed significant relationship with coronary disease severity. In our study with a cohort of Turkish patients undergoing elective coronary angiography; we concluded that MS should be taken into consideration, especially in non-diabetic patients.
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Affiliation(s)
- S Ertek
- Department of Endocrinology and Metabolic Diseases, Ufuk University, Dr. Ridvan Ege Hospital, Mevlana Bulvari, Ankara, Turkey.
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