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Long-term effects of treatment and response in patients with chronic hepatitis C on quality of life. An international, multicenter, randomized, controlled study.

Bezemer G, Van Gool AR, Verheij-Hart E, Hansen BE, Lurie Y, Esteban JI, Lagging M, Negro F, Zeuzem S, Ferrari C, Pawlotsky JM, Neumann AU, Schalm SW, de Knegt RJ, DITTO-HCV Study Gro - BMC Gastroenterol (2012)

Bottom Line: HRQL improves after successful treatment.Treatment schedule did not influence the course of HRQL.Our results do not exclude a more profound negative impact of individualized treatment compared to standard, possibly caused by higher doses and extended treatment duration in the individualized group.

View Article: PubMed Central - HTML - PubMed

Affiliation: Dpt, Gastroenterology & Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands.

ABSTRACT

Background: Hepatitis C decreases health related quality of life (HRQL) which is further diminished by antiviral therapy. HRQL improves after successful treatment. This trial explores the course of and factors associated with HRQL in patients given individualized or standard treatment based on early treatment response (Ditto-study).

Methods: The Short Form (SF)-36 Health Survey was administered at baseline (n = 192) and 24 weeks after the end of therapy (n = 128).

Results: At baseline HRQL was influenced by age, participating center, severity of liver disease and income. Exploring the course of HRQL (scores at follow up minus baseline), only the dimension general health increased. In this dimension patients with a relapse or sustained response differed from non-responders. Men and women differed in the dimension bodily pain. Treatment schedule did not influence the course of HRQL.

Conclusions: Main determinants of HRQL were severity of liver disease, age, gender, participating center and response to treatment. Our results do not exclude a more profound negative impact of individualized treatment compared to standard, possibly caused by higher doses and extended treatment duration in the individualized group. Antiviral therapy might have a more intense and more prolonged negative impact on females.

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Related in: MedlinePlus

Mean scores with 95% confidence intervals of the different dimensions of the SF-36 in females at baseline and at 24 weeks after completion of treatment (follow up).
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Figure 4: Mean scores with 95% confidence intervals of the different dimensions of the SF-36 in females at baseline and at 24 weeks after completion of treatment (follow up).

Mentions: Neither age, genotype nor grade of fibrosis had an influence on changes in the different dimensions of HRQL. A significant difference was seen between men and women in the dimensions bodily pain (males: + 4.1, females: - 7.2, p = .02), social functioning (males: + 6.3, females: - 5.8, p = .008), vitality (males: + 7.2, females: - 2.7, p = .03) and role limitations due to emotional problems (males: + 9.3, females: - 8.3, p = .05). There was a weak significant positive correlation between income in Euros and increase in vitality and mental health between baseline and follow up: correlation coefficient .30 (p = .02) for vitality and .21 (p = .03) for mental health. See Figure 3 and 4.


Long-term effects of treatment and response in patients with chronic hepatitis C on quality of life. An international, multicenter, randomized, controlled study.

Bezemer G, Van Gool AR, Verheij-Hart E, Hansen BE, Lurie Y, Esteban JI, Lagging M, Negro F, Zeuzem S, Ferrari C, Pawlotsky JM, Neumann AU, Schalm SW, de Knegt RJ, DITTO-HCV Study Gro - BMC Gastroenterol (2012)

Mean scores with 95% confidence intervals of the different dimensions of the SF-36 in females at baseline and at 24 weeks after completion of treatment (follow up).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3293759&req=5

Figure 4: Mean scores with 95% confidence intervals of the different dimensions of the SF-36 in females at baseline and at 24 weeks after completion of treatment (follow up).
Mentions: Neither age, genotype nor grade of fibrosis had an influence on changes in the different dimensions of HRQL. A significant difference was seen between men and women in the dimensions bodily pain (males: + 4.1, females: - 7.2, p = .02), social functioning (males: + 6.3, females: - 5.8, p = .008), vitality (males: + 7.2, females: - 2.7, p = .03) and role limitations due to emotional problems (males: + 9.3, females: - 8.3, p = .05). There was a weak significant positive correlation between income in Euros and increase in vitality and mental health between baseline and follow up: correlation coefficient .30 (p = .02) for vitality and .21 (p = .03) for mental health. See Figure 3 and 4.

Bottom Line: HRQL improves after successful treatment.Treatment schedule did not influence the course of HRQL.Our results do not exclude a more profound negative impact of individualized treatment compared to standard, possibly caused by higher doses and extended treatment duration in the individualized group.

View Article: PubMed Central - HTML - PubMed

Affiliation: Dpt, Gastroenterology & Hepatology, Erasmus University Medical Center, Rotterdam, The Netherlands.

ABSTRACT

Background: Hepatitis C decreases health related quality of life (HRQL) which is further diminished by antiviral therapy. HRQL improves after successful treatment. This trial explores the course of and factors associated with HRQL in patients given individualized or standard treatment based on early treatment response (Ditto-study).

Methods: The Short Form (SF)-36 Health Survey was administered at baseline (n = 192) and 24 weeks after the end of therapy (n = 128).

Results: At baseline HRQL was influenced by age, participating center, severity of liver disease and income. Exploring the course of HRQL (scores at follow up minus baseline), only the dimension general health increased. In this dimension patients with a relapse or sustained response differed from non-responders. Men and women differed in the dimension bodily pain. Treatment schedule did not influence the course of HRQL.

Conclusions: Main determinants of HRQL were severity of liver disease, age, gender, participating center and response to treatment. Our results do not exclude a more profound negative impact of individualized treatment compared to standard, possibly caused by higher doses and extended treatment duration in the individualized group. Antiviral therapy might have a more intense and more prolonged negative impact on females.

Show MeSH
Related in: MedlinePlus