Publication: Impacto de un programa de atención farmacéutica especializada al paciente con infección por el virus de la hepatitis C en tratamiento con antivirales de acción directa
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2019-02-13
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Universidad Complutense de Madrid
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Abstract
La infección por el virus de la hepatitis C (VHC) es un problema sociosanitario de gran relevancia.Constituye la principal causa de cirrosis hepática y carcinoma hepatocelular, y de mortalidad asociada a enfermedad hepática crónica a nivel mundial. Las estimaciones realizadas por la Organización Mundial de la Salud, con datos de 2015, indican que el 1% de la población mundial presentaba infección crónica por el VHC y que la mortalidad anual por enfermedades hepáticas relacionadas con la infección alcanzaba a 399.000 personas. En aquel momento, únicamente el 20% de los casos de infección por el VHC estaba diagnosticado, y sólo el 7,4% de los pacientes diagnosticados habían sido tratados.La aparición de los antivirales de acción directa (AAD) para el VHC ha supuesto una revolución y un cambio de paradigma en el tratamiento en los pacientes con esta infección. Según los ensayos clínicos, distintas combinaciones de estos fármacos permiten obtener porcentajes de respuesta viral sostenida (RVS) superiores al 90% en la mayoría de los casos. Además, los AAD son bien tolerados y permiten la administración de regímenes más cortos que los basados en interferón, también a las poblaciones de pacientes cuya situación clínica es más grave...
Hepatitis C virus (HCV) infection generates a major public health burden. It is the main cause of liver cirrhosis and hepatocellular carcinoma. It is also the main cause of mortality associated with chronic liver disease worldwide. In 2015, the Worl Health Organization estimated that 1% of the world population had chronic HCV infection and that 399,000 people annually died from liver diseases. At that time, only 20% of HCV infection cases were diagnosed, and only 7.4% of the patients diagnosed had been treated.The arrival of direct action antivirals (DAA) for HCV has led to a revolution and a paradigm shift in the treatment of patients with this infection. According to clinical trials, different combinations of these drugs allow percentages of sustained viral response (SVR) higher than 90% in most of the cases. In addition, DDAs are well tolerated and allow the administration of shorter regimens than those based on interferon, also for patient populations with more severe liver disease. Furthermore, the improvement in the prognosis of patients has been of such magnitude that a demand for urgent treatment has been generated to this group, in many cases without solid scientific evidence to endorse the use of these new drugs. This fact is particularly important in the population of cirrhotic patients, less represented in clinical trials and for whom the effectiveness of antiviral regimens continue to be lower than in non-cirrhotic patients..
Hepatitis C virus (HCV) infection generates a major public health burden. It is the main cause of liver cirrhosis and hepatocellular carcinoma. It is also the main cause of mortality associated with chronic liver disease worldwide. In 2015, the Worl Health Organization estimated that 1% of the world population had chronic HCV infection and that 399,000 people annually died from liver diseases. At that time, only 20% of HCV infection cases were diagnosed, and only 7.4% of the patients diagnosed had been treated.The arrival of direct action antivirals (DAA) for HCV has led to a revolution and a paradigm shift in the treatment of patients with this infection. According to clinical trials, different combinations of these drugs allow percentages of sustained viral response (SVR) higher than 90% in most of the cases. In addition, DDAs are well tolerated and allow the administration of shorter regimens than those based on interferon, also for patient populations with more severe liver disease. Furthermore, the improvement in the prognosis of patients has been of such magnitude that a demand for urgent treatment has been generated to this group, in many cases without solid scientific evidence to endorse the use of these new drugs. This fact is particularly important in the population of cirrhotic patients, less represented in clinical trials and for whom the effectiveness of antiviral regimens continue to be lower than in non-cirrhotic patients..
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Tesis de la Universidad Complutense de Madrid, Facultad de Farmacia, leída el 19-07-2018