Abstract:
PURPOSE:We sought to determine the incidence and risks for severe thrombocytopenia (platelets < 50,000/μL) in United States Veteran patients treated with pegylated interferon (PEG-IFN) plus ribavirin for hepatitis C virus-positive (HCV) chronic liver disease (CLD). METHODS:Using a retrospective, observational cohort study design to analyze databases from the New England Veterans Healthcare System, we identified 979 patients diagnosed with HCV-positive CLD treated solely with PEG-IFN plus ribavirin. The cohort was stratified by pre-treatment platelet counts of 50,000-100,000/μL (N = 90), >100,000-150,000/μL (N = 162), and >150,000μL (N = 727). The cumulative incidence of severe thrombocytopenia and major bleeding events were determined for each baseline platelet group for 48 weeks following treatment initiation. Multivariable Cox regression was used to identify risk factors for incident severe thrombocytopenia. RESULTS:Overall, severe thrombocytopenia occurred in 6.1% (N = 60), but in 41.1% of patients with pre-treatment platelet counts 50, 000-100,000/μL compared with 11.7% (p < 0.001) and 0.55% (p < 0.001) in the two higher pre-treatment platelet groups. Most episodes occurred within the first 12 weeks of treatment. Median nadir count for these 60 patients was 35,000/μL (inter-quartile range 28,000, 44,000). Baseline platelet counts of 50,000-100,000/μL [adjusted hazard ratio (HR) = 3.81; 95%CI = 2.07-7.00] and hemoglobin <10 g/dL (adjusted HR = 3.39; 95%CI = 1.45-7.960) associated with severe thrombocytopenia. Major bleeding events during the 48-week observation period were rare (N = 5, 0.51%). CONCLUSIONS:The incidence of severe thrombocytopenia in a large, observational cohort of veteran patients with HCV CLD treated with PEG-IFN plus ribavirin was 6.1%. Low pre-treatment platelet counts and hemoglobin levels associated with early, incident severe thrombocytopenia.
journal_name
Pharmacoepidemiol Drug Safjournal_title
Pharmacoepidemiology and drug safetyauthors
Hermos JA,Quach L,Gagnon DR,Weber HC,Altincatal A,Cho K,Lawler EV,Grotzinger KMdoi
10.1002/pds.3585subject
Has Abstractpub_date
2014-05-01 00:00:00pages
480-8issue
5eissn
1053-8569issn
1099-1557journal_volume
23pub_type
杂志文章abstract:OBJECTIVE:To learn the evolution of antidepressant and lithium use in Castilla y León (Central Spain) and its relationship with suicide rates. METHODS:A search in the ECOM (Especialidades Consumo de Medicamentos) database of the Spanish Ministry of Health for antidepressants and lithium was carried out for the period ...
journal_title:Pharmacoepidemiology and drug safety
pub_type: 杂志文章
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journal_title:Pharmacoepidemiology and drug safety
pub_type: 杂志文章,评审
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journal_title:Pharmacoepidemiology and drug safety
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journal_title:Pharmacoepidemiology and drug safety
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journal_title:Pharmacoepidemiology and drug safety
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abstract::An information-theoretic definition of similarity proposed by Dekang Lin in 1998 appears to have attractive properties for identifying medically similar cases in a large database. Examination of similar cases that appear following vaccination may provide a way of detecting previously unexpected associations. A key ele...
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pub_type: 杂志文章,随机对照试验
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journal_title:Pharmacoepidemiology and drug safety
pub_type: 杂志文章
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更新日期:1998-11-01 00:00:00
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更新日期:2018-05-01 00:00:00
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journal_title:Pharmacoepidemiology and drug safety
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更新日期:2020-12-27 00:00:00
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journal_title:Pharmacoepidemiology and drug safety
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pub_type: 杂志文章,评审
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更新日期:2019-09-01 00:00:00
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journal_title:Pharmacoepidemiology and drug safety
pub_type: 杂志文章
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更新日期:2001-12-01 00:00:00
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journal_title:Pharmacoepidemiology and drug safety
pub_type: 杂志文章
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更新日期:2016-03-01 00:00:00
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更新日期:2003-07-01 00:00:00
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journal_title:Pharmacoepidemiology and drug safety
pub_type: 杂志文章
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更新日期:2009-09-01 00:00:00
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journal_title:Pharmacoepidemiology and drug safety
pub_type: 杂志文章
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更新日期:2017-09-01 00:00:00
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journal_title:Pharmacoepidemiology and drug safety
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更新日期:2012-11-01 00:00:00
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pub_type: 杂志文章
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更新日期:2014-04-01 00:00:00
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journal_title:Pharmacoepidemiology and drug safety
pub_type: 杂志文章
doi:10.1002/pds.1265
更新日期:2006-09-01 00:00:00