Survival benefit of DAA-induced SVR in patients with decompensated cirrhosis

Survival benefit of DAA-induced SVR in patients with decompensated cirrhosis
Kim WR, AASLD 2017, Abs. LB-27

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Comparison (standardized mortality ratio) of

  • Observed incidence of deaths from start of DAA therapy in patients with hepatic decompensation (Child-Pugh B or C) in SOLAR-1 and SOLAR-2 studies
    • LDV/SOF + RBV for 12 or 24 weeks, n = 212 (123 Child B and 89 Child C)
  • With mortality predicted by survival models derived from HCV patients with hepatic decompensation in the pre-DAA era

Survival model derived from liver transplant candidates with hepatic decompensation (Organ Procurement and Transplantation Network)

  • Model development: HCV patients on the waiting list as of Jan 1, 2007
  • Model validation: HCV patients on the waiting list as of Jan 1, 2008
  • Selected patients meeting the SOLAR studies eligibility criteria

Observed versus expected mortality

  • SOLAR studies: 15 deaths within 1 year of therapy
  • Standardized mortality ratio: not different for the first 100 days, significantly reduced thereafter