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. 2022 Jan;17(1):43-51.
doi: 10.1007/s11739-021-02741-9. Epub 2021 Apr 28.

Comorbidities impact and de-prescribing in elderly with HCV-related liver disease: analysis of a prospective cohort

Anna Licata  1 , Maria Giovanna Minissale  2 , Lydia Giannitrapani  2   3 , Filippo A Montalto  2 , Clelia Lombardo  2 , Luigi Mirarchi  2 , Simona Amodeo  2 , Maurizio Soresi  2 , Giuseppe Montalto  2
Affiliations

Comorbidities impact and de-prescribing in elderly with HCV-related liver disease: analysis of a prospective cohort

Anna Licata et al. Intern Emerg Med. 2022 Jan.

Abstract

Management for HCV has undergone a notable change using direct-acting antiviral drugs (DAAs), which are safe and effective even in elderly. Here, we define impact of comorbidities, concomitant medication and drug-drug interactions in elder patients with HCV related disease before starting DAAs regimen. We analyzed data of 814 patients prospectively enrolled at our Unit within the web based model HCV Sicily Network. Out of 814, 590 were treated with DAAs and 414 of them were older than 65 years. We divided those 414 in two groups, one including 215 patients, aged between 65 and 74 years, and another with 199 patients, aged of 75 years and over. Charlson Comorbidity Index (CCI) was assessed for each patient; drug-drug interactions (DDI) and de-prescribing process were carried out appropriately. Within 414 patients included, percentage rates of women treated was higher than males, BMI was lower and cirrhosis was frequently reported in patients older than 75 years. Hypertension, diabetes mellitus, dyslipidemia (p < 0.0001), prostatic pathologies, kidney disease, gastrointestinal disease (p < 0.0001), osteoporosis (p < 0.01) and depression were most common co-morbidities. CCI showed lower scores in the first group as compared with the second one (p < 0.0001). Among drugs, statins were frequently suspended and anti-hypertensive often replaced. DAAs are useful and effective regardless of disease severity, comorbidities, medications and age. De-prescribing allows a stable reduction of number of medications taken with real improvement of quality of life.

Keywords: Charlson Index; Co-morbidities; DDI interactions; De-prescribing; Elderly; HCV.

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Conflict of interest statement

The authors declare they have no conflict of interest.

Figures

Fig. 1
Fig. 1
Analysis of differences within CCI in patients younger and older than 75 years: mean number of comorbidities was 5 (3–10) in younger and 6 (5–11) in older than 75
Fig. 2
Fig. 2
Analysis of percentages of comorbidities 1–3, 4–6, > 6, according different age classes (years)
See this image and copyright information in PMC

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