Efficacy and safety of glecaprevir and pibrentasvir combination therapy in old-aged patients with chronic hepatitis C virus infection / Journal of Rural Medicine

Objective: Combination therapy with glecaprevir and pibrentasvir (G/P) has been shown to provide a sustained virologic response (SVR) rate of >97% in patients with chronic hepatitis C virus (HCV) infection in the first published real-world Japanese data. However, a recently published study showed that the treatment was often discontinued in patients ≥75 years old, resulting in low SVR in intention-to-treat (ITT) analysis. Thus, our aim was to evaluate real-world data for G/P therapy in patients ≥75 years of age, the population density of which is high in “rural” regions.Patients and Methods: We conducted a multicenter study to assess the efficacy and safety of G/P therapy for chronic HCV infection, in the North Kanto area in Japan.Results: Of the 308 patients enrolled, 294 (95.5%) completed the treatment according to the protocol. In ITT and per-protocol analyses, the overall SVR12 rate was 97.1% and 99.7%, respectively. The old-aged patients group consisted of 59 participants, 56 of whom (94.9%) completed the scheduled protocol. Although old-aged patients tended to have non-SVR factors such as liver cirrhosis, history of HCC, and prior DAA therapies, the SVR12 rates in old-aged patients were 98.3% and 100% in the ITT and PP analyses, respectively. Of 308 patients enrolled, adverse events were observed in 74 patients (24.0%), with grade ≥3 events in 8 patients (2.6%). There was no significant difference in any grade and grade ≥3 adverse events between the old-aged group and the rest of the study participants. Only one patient discontinued the treatment because of adverse events.Conclusion: G/P therapy is effective and safe for old-aged patients.

Situación laboral, económica y académica de los médicos de la región metropolitana / Employment, economic and academic situation, as a quality of life dimension of physicians at the metropolitan region

Objetivos: Describir las condiciones laborales, económicas y académicas de un grupo representativo de médicos chilenos de la Región Metropolitana. Investigamos las diferencias de estas características según sexo y edad. Metodología: Estudio cuantitativo, de corte transversal: las variables en estudio se registran a través de instrumento “EVALMED” (1), que es una encuesta anónima, auto-aplicada, realizada previa firma de un consentimiento informado. Los médicos que formaron la muestra fueron seleccionados en forma aleatoria desde la base de datos del Consejo Regional Santiago del Colegio Médico de Chile. Se consideró un 95 por ciento de confi anza, un 5 por ciento de error y una tasa de respuesta del 80 por ciento. Resultados: Se evaluaron 163 médicos (58,9 por ciento varones y 41,1 por ciento mujeres) de todos los rangos de edad. En ellos se encuentran diferencias signifi cativas en los distintos aspectos laborales evaluados entre médicos de ambos sexos; en particular llaman la atención las diferencias por sexo en el tipo de contrato laboral, el ingreso, el tipo de trabajo, horario de trabajo, percepciones sobre el trabajo así como el clima laboral. Todos estos aspectos se presentan en situación de relativa desventaja para las mujeres médicos y para los médicos de edades extremas.

Objectives: To describe the working conditions, economic and academic situation of a representative group of Chilean physicians in the Metropolitan Region. To examine the relationships between these characteristics on one hand, and sex and age, on the other. Methodology: Quantitative, cross sectional design. The variables were recorded by “EVALMED” instrument, which is an anonymous, self-applied instrument. An informed consent document was previously signed by the participants. The physicians who made up the sample were randomly selected from the database of the Regional Medical Council of Santiago. We arranged for 95 percent confi dence and 5 percent error limits and for a response rate of 80 percent. Results: We studied 163 physicians (58.9 percent men and 41.1 percent women) of all age groups. There were significant sex and age differences in the various aspects of labor assessed, in particular in the type of employment contract, income, type of work, working hours, work perceptions and work environment. Women and physicians of both young and senior age groups were found to be at a disadvantage.