Simeprevir plus sofosbuvir for eight or 12 weeks in treatment-naïve and treatment-experienced hepatitis C virus genotype 4 patients with or without cirrhosis

The OSIRIS study investigated efficacy and safety of simeprevir plus sofosbuvir for eight or 12 weeks in hepatitis C virus (HCV) genotype 4-infected patients with METAVIR F0-F4 fibrosis. Sixty-three patients (33 treatment-naïve and 30 peg-interferon/ribavirin (Peg-IFN/RBV)-experienced) enrolled in a partly randomized, open-label, multicentre, phase IIa study. Patients with F0-F3 fibrosis were randomized (1:1) into two groups (A1 and A2), stratified according to treatment experience and METAVIR score, to receive either eight weeks (Group A1, n=20) or 12 weeks (Group A2, n=20) of treatment. Patients with compensated cirrhosis (METAVIR F4) received 12 weeks of treatment (Group B, n=23). Treatment comprised simeprevir 150 mg and sofosbuvir 400 mg daily. The primary efficacy endpoint was sustained virologic response 12 weeks after planned end of treatment (SVR12). Safety and tolerability were assessed throughout. Overall, 92% (95% CI: 82-97) of patients achieved SVR12; 75% (15/20) in Group A1 and 100% in groups A2 and B. Patients who did not achieve SVR12 (n=5) experienced viral relapse during the first 32 days following treatment and were all prior Peg-IFN/RBV null responders. The most commonly reported treatment-emergent adverse events (TEAEs) were asymptomatic lipase increase (14%), pruritus (14%), headache (13%) and hyperbilirubinaemia (11%). No patients discontinued due to TEAEs. In conclusion, simeprevir plus sofosbuvir for 12 weeks achieved a 100% SVR rate in HCV genotype 4-infected patients with or without compensated cirrhosis (ClinicalTrials.gov: NCT02278419). The AE and laboratory profile were favourable and consistent with previous data for simeprevir plus sofosbuvir in eight- and 12-week regimens.

Perceptions of medical students towards antibiotic prescribing for upper respiratory tract infections in Saudi Arabia

Introduction

This survey evaluates knowledge, attitudes and practices of medical students towards use of antibiotics for upper respiratory infections (URTIs).

Methodology

Cross-sectional questionnaire study among 1042 randomly selected medical students in Saudi Arabia.

Results

Respondents were mostly Saudis (97.5%), had previous knowledge of antibiotics (99.7%) and their usage (98.3%) against bacterial infections (93.7%). 18.1% thought that they could be used for viral infections. Nearly all students (97.2%) used antibiotics themselves during the previous year and self-medication without a prescription was high at 49% of cases. Most antibiotics were taken for URTI symptoms (61.8%). Female medical students had better knowledge on antibiotic effectiveness against bacteria and viruses, and overall knowledge increased with study year. Health seeking behaviour rates for symptoms of RTI and associated estimated necessity for antibiotics varied but were highest for cough with yellow/green phlegm.

Conclusions

The depth of knowledge that healthcare professionals have in relation to the proper use of antibiotics is essential in spreading the right message within communities. This is the first large study among medical students in Saudi Arabia, shedding important light on areas for improvement in the medical curriculum as well as antibiotic practices of medical students themselves.