Nav: Home

Highly curative hep C treatment safe and effective for drug users

August 08, 2016

1. Research supports removing drug use as a restriction for receiving highly curative hep C treatment
Abstract: http://www.annals.org/article.aspx?doi=10.7326/M16-0816
URL goes live when the embargo lifts

Hep C patients being treated for opioid addiction achieved high rates of sustained virologic response after 12 weeks of therapy with elbasvir-grazoprevir compared to those taking placebo for 12 weeks before beginning the drug treatment. The patients in the elbasvir-grazoprevir group saw a reduced viral load, regardless of ongoing drug use. The results of a randomized, controlled trial are published in Annals of Internal Medicine.

Up to 170 million people worldwide have hepatitis C virus (HCV) infection and injection drug use is a major risk factor. While the once-daily dosing, low side-effects profile, and shortened treatment duration of interferon-free direct-acting antivirals are ideal for injection drug users, most trials of these therapies for HCV have excluded persons with recent injection drug use.

The CO-STAR (Hepatitis C Patients on Opioid Substitution Therapy Antiviral Response) trial sought to evaluate the efficacy and safety of elbasvir-grazoprevir for injection drug users. Researchers assigned 301 treatment-naive patients with chronic HCV genotype 1, 4, or 6 infection who were at least 80 percent adherent to visits for opioid-agonist therapy to immediate treatment with elbasvir-grazoprevir for 12 weeks, or deferred treatment with placebo for 12 weeks, then open-label elbasvir-grazoprevir for 12 weeks. They found that 91.5 percent of the patients in the immediate treatment group achieved sustained virologic response, regardless of ongoing drug use. According to the authors, these results suggest that drug use should be removed as a barrier to interferon-free HCV therapy for patients being treated for opioid addiction.

Note: For an embargoed PDF, please contact Cara Graeff. To reach the lead author, Dr. Gregory Dore, please contact Lucienne Bamford at Lbamford@kirby.unsw.edu.au.




2. Evidence lacking to evaluate the benefits and harms of lipid screening in younger adults
Abstract: http://www.annals.org/article.aspx?doi=10.7326/M16-0946
URL goes live when the embargo lifts

Investigators for the U.S. Preventive Services Task Force (USPSTF) found a lack of evidence on the benefits and harms of screening for lipid disorders, or dyslipidemia, in younger adults. Their report is published in Annals of Internal Medicine.

More than half of U.S. adults are affected by lipid disorders, which are associated with cardiovascular disease. While dyslipidemia becomes more prevalent with age, it also affects younger adults. Since dyslipidemia it is asymptomatic before cardiovascular disease develops, early detection with screening could allow for young adults to implement prevention strategies to reduce their risk for cardiovascular events.

In 2008, the USPSTF recommended lipid screening in men aged 20 to 35 and women aged 20 to 45 years with CHD risk factors. Although the USPSTF found no direct evidence regarding benefits or harms of lipid screening within these age groups, its recommendation was based on data showing that some younger adults with CHD risk factors have lipid levels sufficient to place them at high 10-year cardiovascular risk and might benefit from lipid-lowering therapies. The purpose of this review was to update previous USPSTF reviews on screening for dyslipidemia in younger adults. The USPSTF did not re-review evidence on screening for dyslipidemia for older adults because it already strongly recommends screening in men older than 35 and women older than 45.

In their review, the researchers found no direct evidence regarding benefits and harms of dyslipidemia screening or treatment in younger adults. They conclude that estimating the potential effects of screening for dyslipidemia in a younger population will require extrapolation from studies performed in older adults.

Note: For an embargoed PDF, please contact Cara Graeff. The lead author, Dr. Roger Chou, can be reached through Ariane Holm Le Chevallier at holma@ohsu.edu or 503-494-4158.
-end-
Also in this issue:
Human Trafficking: The Role of Medicine in Interrupting the Cycle of Abuse and Violence
Wendy Macias-Konstantopoulos, MD, MPH
Medicine and Public Issues
Abstract: http://www.annals.org/article.aspx?doi=10.7326/M16-0094

American College of Physicians

Related Cardiovascular Disease Articles:

A talk with your GP may prevent cardiovascular disease
Having a general practitioner (GP) who is trained in motivational interviewing may reduce your risk of getting cardiovascular disease.
Dilemma of COVID-19, aging and cardiovascular disease
Whether individuals should continue to take angiotensin-converting enzyme inhibitors and angiotensin receptor blockers in the context of coronavirus disease 2019 (COVID-19) is discussed in this article.
Air pollution linked to dementia and cardiovascular disease
People continuously exposed to air pollution are at increased risk of dementia, especially if they also suffer from cardiovascular diseases, according to a study at Karolinska Institutet in Sweden published in the journal JAMA Neurology.
New insights into the effect of aging on cardiovascular disease
Aging adults are more likely to have - and die from - cardiovascular disease than their younger counterparts.
Premature death from cardiovascular disease
National data were used to examine changes from 2000 to 2015 in premature death (ages 25 to 64) from cardiovascular disease in the United States.
Ultrasound: The potential power for cardiovascular disease therapy
In the current issue of Cardiovascular Innovations and Applications volume 4, issue 2, pp.
Despite the ACA, millions of Americans with cardiovascular disease still can't get care
Cardiovascular disease (CVD) is the leading cause of death for Americans, yet millions with CVD or cardiovascular risk factors (CVRF) still can't access the care they need, even years after the implementation of the Affordable Care Act (ACA).
Excess weight and body fat cause cardiovascular disease
In the first Mendelian randomization study to look at this, researchers have found evidence that excess weight and body fat cause a range of heart and blood vessel diseases (rather than just being associated with it).
Enzyme may indicate predisposition to cardiovascular disease
Study suggests that people with low levels of PDIA1 in blood plasma may be at high risk of thrombosis; this group also investigated PDIA1's specific interactions in cancer.
Cardiovascular disease in China
This study analyzed data from the Global Burden of Disease Study to look at the rate of cardiovascular disease (CVD) in China along with death and disability from CVD from 1990 to 2016.
More Cardiovascular Disease News and Cardiovascular Disease Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Making Amends
What makes a true apology? What does it mean to make amends for past mistakes? This hour, TED speakers explore how repairing the wrongs of the past is the first step toward healing for the future. Guests include historian and preservationist Brent Leggs, law professor Martha Minow, librarian Dawn Wacek, and playwright V (formerly Eve Ensler).
Now Playing: Science for the People

#565 The Great Wide Indoors
We're all spending a bit more time indoors this summer than we probably figured. But did you ever stop to think about why the places we live and work as designed the way they are? And how they could be designed better? We're talking with Emily Anthes about her new book "The Great Indoors: The Surprising Science of how Buildings Shape our Behavior, Health and Happiness".
Now Playing: Radiolab

The Third. A TED Talk.
Jad gives a TED talk about his life as a journalist and how Radiolab has evolved over the years. Here's how TED described it:How do you end a story? Host of Radiolab Jad Abumrad tells how his search for an answer led him home to the mountains of Tennessee, where he met an unexpected teacher: Dolly Parton.Jad Nicholas Abumrad is a Lebanese-American radio host, composer and producer. He is the founder of the syndicated public radio program Radiolab, which is broadcast on over 600 radio stations nationwide and is downloaded more than 120 million times a year as a podcast. He also created More Perfect, a podcast that tells the stories behind the Supreme Court's most famous decisions. And most recently, Dolly Parton's America, a nine-episode podcast exploring the life and times of the iconic country music star. Abumrad has received three Peabody Awards and was named a MacArthur Fellow in 2011.