Comorbidities and the use of comedications among patients with chronic hepatitis C in Korea: A nationwide cross-sectional study
Background/Aims Chronic hepatitis C (CHC) is the second leading cause of liver-related mortality and is more prevalent in the elderly population in Korea. Decisions to initiate treatment and selection of proper antiviral agents may be challenging among elderly patients due to relevant comorbidities,...
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| Format: | Article |
| Language: | English |
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The Korean Association of Internal Medicine
2023-05-01
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| Series: | The Korean Journal of Internal Medicine |
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| Online Access: | http://www.kjim.org/upload/kjim-2022-215.pdf |
| _version_ | 1797831015760134144 |
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| author | Kyung Min Kwon Jae-Jun Shim Gi-Ae Kim Bo Ok Kim Helin Han Hyun Jung Ahn |
| author_facet | Kyung Min Kwon Jae-Jun Shim Gi-Ae Kim Bo Ok Kim Helin Han Hyun Jung Ahn |
| author_sort | Kyung Min Kwon |
| collection | DOAJ |
| description | Background/Aims Chronic hepatitis C (CHC) is the second leading cause of liver-related mortality and is more prevalent in the elderly population in Korea. Decisions to initiate treatment and selection of proper antiviral agents may be challenging among elderly patients due to relevant comorbidities, comedications, and drug-drug interaction (DDI). It may be helpful to understand the current demographic status and comorbidities of CHC patients in the country. Methods Patients aged ≥ 18 years and diagnosed with CHC (KCD-7 code B18.2) were extracted from the Korean Health Insurance Review & Assessment Service database in 2018. Data on comorbidities and comedications were assessed and potential DDIs were analyzed. Results A total of 50,476 patients with CHC, with a mean age of 60.3 years and 46.7% male patients were identified. The proportion of patients with cirrhosis, hepatocellular carcinoma, and liver transplantation was 6.0%, 4.1%, and 0.3%, respectively and 37.2% of patients were more than 65 years of age. The three most common comorbidities were diseases of the digestive system (83.7%), respiratory system (58.2%), and musculoskeletal system and connective tissue (57.6%). The three most common comedications were analgesics (91.6%), gastrointestinal agents (85%), and antibacterials (80.3%). Lipid-lowering agents and anticonvulsants were prescribed in 28.5% and 14.8% of patients. Rate of potential DDI for contraindication was 2.2%, 13.1%, and 15.6% with sofosbuvir/velpatasvir, ledipasvir/sofosbuvir, and glecaprevir/pibrentasvir. Conclusions With the increasing age of patients with CHC, comorbidity, comedication, and potential DDI should be considered when choosing antivirals in Korea. Sofosbuvir-based regimens showed favorable DDI profiles among Korean patients. |
| first_indexed | 2024-04-09T13:46:03Z |
| format | Article |
| id | doaj.art-85910d28342f43f881f0b395386a382b |
| institution | Directory Open Access Journal |
| issn | 1226-3303 2005-6648 |
| language | English |
| last_indexed | 2024-04-09T13:46:03Z |
| publishDate | 2023-05-01 |
| publisher | The Korean Association of Internal Medicine |
| record_format | Article |
| series | The Korean Journal of Internal Medicine |
| spelling | doaj.art-85910d28342f43f881f0b395386a382b2023-05-09T04:52:47ZengThe Korean Association of Internal MedicineThe Korean Journal of Internal Medicine1226-33032005-66482023-05-0138333834810.3904/kjim.2022.215170782Comorbidities and the use of comedications among patients with chronic hepatitis C in Korea: A nationwide cross-sectional studyKyung Min Kwon0Jae-Jun Shim1Gi-Ae Kim2Bo Ok Kim3Helin Han4Hyun Jung Ahn5 Gilead Sciences, Foster City, CA, USA Department of Internal Medicine, Kyung Hee University College of Medicine, Seoul, Korea Department of Internal Medicine, Kyung Hee University College of Medicine, Seoul, Korea Cerner Enviza, Seoul, Korea Cerner Enviza, Seoul, Korea Cerner Enviza, Seoul, KoreaBackground/Aims Chronic hepatitis C (CHC) is the second leading cause of liver-related mortality and is more prevalent in the elderly population in Korea. Decisions to initiate treatment and selection of proper antiviral agents may be challenging among elderly patients due to relevant comorbidities, comedications, and drug-drug interaction (DDI). It may be helpful to understand the current demographic status and comorbidities of CHC patients in the country. Methods Patients aged ≥ 18 years and diagnosed with CHC (KCD-7 code B18.2) were extracted from the Korean Health Insurance Review & Assessment Service database in 2018. Data on comorbidities and comedications were assessed and potential DDIs were analyzed. Results A total of 50,476 patients with CHC, with a mean age of 60.3 years and 46.7% male patients were identified. The proportion of patients with cirrhosis, hepatocellular carcinoma, and liver transplantation was 6.0%, 4.1%, and 0.3%, respectively and 37.2% of patients were more than 65 years of age. The three most common comorbidities were diseases of the digestive system (83.7%), respiratory system (58.2%), and musculoskeletal system and connective tissue (57.6%). The three most common comedications were analgesics (91.6%), gastrointestinal agents (85%), and antibacterials (80.3%). Lipid-lowering agents and anticonvulsants were prescribed in 28.5% and 14.8% of patients. Rate of potential DDI for contraindication was 2.2%, 13.1%, and 15.6% with sofosbuvir/velpatasvir, ledipasvir/sofosbuvir, and glecaprevir/pibrentasvir. Conclusions With the increasing age of patients with CHC, comorbidity, comedication, and potential DDI should be considered when choosing antivirals in Korea. Sofosbuvir-based regimens showed favorable DDI profiles among Korean patients.http://www.kjim.org/upload/kjim-2022-215.pdfhepatitis cdrug interactionspolypharmacyantiviral agentstherapeutic usecomorbidity |
| spellingShingle | Kyung Min Kwon Jae-Jun Shim Gi-Ae Kim Bo Ok Kim Helin Han Hyun Jung Ahn Comorbidities and the use of comedications among patients with chronic hepatitis C in Korea: A nationwide cross-sectional study The Korean Journal of Internal Medicine hepatitis c drug interactions polypharmacy antiviral agents therapeutic use comorbidity |
| title | Comorbidities and the use of comedications among patients with chronic hepatitis C in Korea: A nationwide cross-sectional study |
| title_full | Comorbidities and the use of comedications among patients with chronic hepatitis C in Korea: A nationwide cross-sectional study |
| title_fullStr | Comorbidities and the use of comedications among patients with chronic hepatitis C in Korea: A nationwide cross-sectional study |
| title_full_unstemmed | Comorbidities and the use of comedications among patients with chronic hepatitis C in Korea: A nationwide cross-sectional study |
| title_short | Comorbidities and the use of comedications among patients with chronic hepatitis C in Korea: A nationwide cross-sectional study |
| title_sort | comorbidities and the use of comedications among patients with chronic hepatitis c in korea a nationwide cross sectional study |
| topic | hepatitis c drug interactions polypharmacy antiviral agents therapeutic use comorbidity |
| url | http://www.kjim.org/upload/kjim-2022-215.pdf |
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