A survey of hepatitis C treatment clinical practice patterns using the newly approved protease inhibitors.


GOALS:To describe current hepatitis C virus (HCV) treatment practices in the United States and identify physician characteristics associated with the use of first generation direct-acting antivirals (DAAs). BACKGROUND:HCV treatment practice patterns have not been assessed after the introduction of DAA, which are now considered standard of care for most HCV genotype 1 patients. STUDY:We sampled nationally representative physicians treating HCV patients with DAAs through a web-based survey. Stepwise multivariate logistic regression was performed to identify physician characteristics associated with the use of DAAs in 4 clinical vignettes (early stage fibrosis, prior null response, human immunodeficiency virus (HIV) co-infection, and post-liver transplantation). RESULTS:Of 1658 deliverable emails, 337 (20.3%) clinicians responded. Fifty percent of providers recommended DAA therapy for treatment-naive patients with early stage fibrosis, whereas 49% of providers would await new therapies. For prior null responders with significant fibrosis, 74% would attempt retreatment using DAAs and 26% would await new therapies. Off-label use of DAAs was recommended by 69% of providers for patients with HIV infection and 48% of providers for post-liver transplant patients. Academic affiliation was significantly associated with higher rates of off-label use in both HIV and post-liver transplant patients. CONCLUSIONS:Despite more potent and less toxic therapies on the horizon, many physicians recommended DAAs in treatment-naive patients with early stage fibrosis. Providers also frequently recommended DAAs for off-label uses, such as treating post-liver transplant patients and those coinfected with HIV.


J Clin Gastroenterol


Chen EY,Lee WM,Hynan LS,Singal AG




Has Abstract


2013-10-01 00:00:00












  • Barrett's mucosa with multiple carcinomas of the esophagus and oral cavity.

    abstract::A 62-year-old man with carcinoma of the tongue had two separate asymptomatic carcinomas of the esophagus, one squamous and the other adenocarcinoma arising from Barrett's mucosa. We review the multicentric origin and synchronous occurrence of tumors in the oropharyngoesophageal area with and without Barrett's mucosa t...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章,评审


    authors: Sheahan DG,Berman MA

    更新日期:1986-02-01 00:00:00

  • Tacrolimus therapy as an alternative to thiopurines for maintaining remission in patients with refractory ulcerative colitis.

    abstract:BACKGROUND:Although the efficacy of tacrolimus for inducing remission of refractory ulcerative colitis (UC) is established, its efficacy for maintaining remission of UC has not been evaluated. AIM:The aim of this study was to evaluate the efficacy of tacrolimus compared with thiopurines for maintaining remission in pa...

    journal_title:Journal of clinical gastroenterology

    pub_type: 临床试验,杂志文章


    authors: Yamamoto S,Nakase H,Matsuura M,Masuda S,Inui K,Chiba T

    更新日期:2011-07-01 00:00:00

  • Emergency Department Burden of Gastroparesis in the United States, 2006 to 2013.

    abstract:BACKGROUND AND AIMS:Gastroparesis, a chronic gastrointestinal disorder defined by delayed stomach emptying in the absence of obstruction, is often associated with frequent and costly visits to the emergency department (ED). The aim of this study was to analyze trends in gastroparesis-related ED visits from 2006 to 2013...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章


    authors: Hirsch W,Nee J,Ballou S,Petersen T,Friedlander D,Lee HN,Cheng V,Lembo A

    更新日期:2019-02-01 00:00:00

  • Patients With Inflammatory Bowel Diseases Are at Higher Risk for Meningitis.

    abstract:BACKGROUND:The epidemiology of meningitis is unknown in inflammatory bowel disease (IBD) patients. GOALS:We aimed to determine the incidence of and risk factors for meningitis in IBD patients. STUDY:We conducted a retrospective cohort and nested case-control study in the Quintiles IMS Legacy PharMetrics Adjudicated C...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章


    authors: Kochar B,Jiang Y,Long MD

    更新日期:2020-05-29 00:00:00

  • Relation among plasma ghrelin level, gastric emptying, and psychologic condition in patients with functional dyspepsia.

    abstract:BACKGROUND AND GOALS:Neurohormonal factors might play a role in the pathogenesis of functional dyspepsia (FD). However, the role of ghrelin, a gastrointestinal hormone that stimulates gastric motility, in FD is not yet clearly defined. The present study was designed to investigate plasma ghrelin levels and their relati...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章


    authors: Takamori K,Mizuta Y,Takeshima F,Akazawa Y,Isomoto H,Ohnita K,Ohba K,Omagari K,Shikuwa S,Kohno S

    更新日期:2007-05-01 00:00:00

  • Pathophysiology and Therapeutic Options for Fecal Incontinence.

    abstract::Fecal incontinence (FI), defined as the involuntary loss of solid or liquid feces through the anus is a prevalent condition with significant effects on quality of life. FI can affect individuals of all ages and in many cases greatly impairs quality of life but, incontinent patients should not accept their debility as ...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章,评审


    authors: Guillaume A,Salem AE,Garcia P,Chander Roland B

    更新日期:2017-04-01 00:00:00

  • Epidemiology and Diagnosis of Gastroparesis in the United States: A Population-based Study.

    abstract:GOALS:We aimed to establish the epidemiological characteristics and documentation of diagnostic workup for gastroparesis (GP). BACKGROUND:No study has used a national database to evaluate the prevalence, demographics, and associated comorbid conditions of GP, and document rates of proper diagnosis. MATERIALS AND METH...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章


    authors: Syed AR,Wolfe MM,Calles-Escandon J

    更新日期:2020-01-01 00:00:00

  • Effect of chemotherapy with 5-fluorouracil on intestinal permeability and absorption in patients with advanced colorectal cancer.

    abstract::5-Fluorouracil (5-FU), in association with leucovorin (LV), is the most used chemotherapy agent in the treatment of colorectal cancer. Response rate, as well as side-effect incidence, increases with the dose intensity of regimens that are used. The most common dose-limiting toxicity for 5-FU/LV modulation is diarrhea....

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章


    authors: Daniele B,Secondulfo M,De Vivo R,Pignata S,De Magistris L,Delrio P,Palaia R,Barletta E,Tambaro R,Carratù R

    更新日期:2001-03-01 00:00:00

  • Clinical, biochemical, and radiologic parameters at admission predicting formation of a pseudocyst in acute pancreatitis.

    abstract:GOALS:To evaluate clinical, biochemical, and radiologic parameters at admission, which predict the development of acute pseudocyst (AP) after acute pancreatitis. BACKGROUND:There is limited data on factors that predict the development of AP. STUDY:Seventy-five consecutive patients with AP were prospectively enrolled ...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章


    authors: Poornachandra KS,Bhasin DK,Nagi B,Sinha SK,Rana SS,Shafiq N,Greer K,Gupta R,Kang M,Malhotra S,Singh K

    更新日期:2011-02-01 00:00:00

  • Rates of Suboptimal Preparation for Colonoscopy Differ Markedly Between Providers: Impact on Adenoma Detection Rates.

    abstract:GOALS:We sought to determine if providers who have higher standards for optimal bowel preparation might be more fastidious in their examination of the colon and, therefore, have higher adenoma detection rates (ADRs). BACKGROUND:ADRs are a reliable and objective marker of colonoscopy performance. Suboptimal bowel prepa...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章


    authors: Mahadev S,Green PH,Lebwohl B

    更新日期:2015-10-01 00:00:00

  • Liver tests in hyperthyroidism: effect of antithyroid therapy.

    abstract::Changes in liver biochemical test results have been described in hyperthyroid patients before and after antithyroid therapy. In the present study, we analyzed liver tests at diagnosis and after 6 weeks of treatment with propylthiouracil (PTU) in 43 patients with hyperthyroidism. At diagnosis, 60.5% of the patients had...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章


    authors: Gürlek A,Cobankara V,Bayraktar M

    更新日期:1997-04-01 00:00:00

  • Gastrointestinal Dysfunction and Neuropathologic Correlations in Parkinson Disease.

    abstract:INTRODUCTION:Recently, an increasing interest to nonmotor symptoms of Parkinson disease (PD) has shown. Gastrointestinal dysfunction is a prominent nonmotor manifestation of PD and precedes motor symptoms for several years. Neuropathologic studies show early accumulation of α-synuclein (α-SYN) in Lewy neurites and Lewy...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章


    authors: Mrabet S,Ben Ali N,Achouri A,Dabbeche R,Najjar T,Haouet S,Belal S

    更新日期:2016-10-01 00:00:00

  • Insulinoma after streptozotocin therapy for metastatic gastrinoma: natural history or iatrogenic complication?

    abstract::Islet cell carcinoma frequently produces more than one chemical product, although its clinical expression is usually restricted to a single hormone. We describe an unusual patient who presented with full-blown metastasizing gastrinoma. He was treated with cimetidine for five years and then streptozotocin therapy, whic...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章


    authors: Bar M,Burke M,Isakov A,Almog C

    更新日期:1990-10-01 00:00:00

  • Endoscopic diagnosis of duodenal neoplasms causing upper gastrointestinal bleeding.

    abstract::Duodenal neoplasms are a rare and not often considered cause of massive upper gastrointestinal bleeding. During a 4-year period, 859 endoscopies in patients with upper gastrointestinal bleeding revealed a duodenal tumor to be the cause of bleeding in eight patients. Three patients had a primary duodenal neoplasm, two ...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章


    authors: Sharon P,Stalnikovicz R,Rachmilewitz D

    更新日期:1982-02-01 00:00:00

  • Atypical cystic carcinoid tumors of the liver.

    abstract::Carcinoid metastases in the liver are typically solid, hypervascular lesions. We report 3 cases of cystic carcinoid tumors in the liver with radiographic findings. Two were metastatic from primary carcinoid tumors of the small intestine and one was not associated with any extra hepatic lesion at presentation or during...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章


    authors: Salamone L,McCarthy S,Salem RR

    更新日期:2010-11-01 00:00:00

  • Hepatitis C virus seroconversion and genotype prevalence in patients and staff on chronic hemodialysis.

    abstract::The prevalence of hepatitis C virus (HCV)-RNA positivity among hemodialysis patients varies between 10 and 70%. Few previous surveys revealed high frequency of seroconversion of HCV-RNA-negative patients over the years of hemodialysis. Only few studies reported HCV genotype variability. We evaluated all 65 patients on...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章


    authors: Zamir D,Storch S,Zonder HB,Zamir C,Weiner P

    更新日期:1999-01-01 00:00:00

  • Efficacy of low-dose antacids in the treatment of peptic ulcers: pharmacological explanation?

    abstract::Antacids have been used as remedies for benign gastroduodenal disorders for centuries. They were regarded to be effective in relieving gastric pain and symptoms of hyperacidity and in promoting ulcer healing. The effectiveness was based on empiric observations and was not derived from the controlled clinical trials da...

    journal_title:Journal of clinical gastroenterology

    pub_type: 临床试验,杂志文章,meta分析


    authors: Sewing KF

    更新日期:1991-01-01 00:00:00

  • Effects of probiotics for the prevention and treatment of radiation-induced diarrhea.

    abstract:BACKGROUND AND AIMS:Probiotic supplementation seems to provide beneficial effects in the prevention and treatment of radiation-induced diarrhea. We performed a systematic review and meta-analysis to estimate the efficacy of probiotic supplementation for prevention and treatment of radiation-induced diarrhea. METHODS:T...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章,meta分析,评审


    authors: Fuccio L,Guido A,Eusebi LH,Laterza L,Grilli D,Cennamo V,Ceroni L,Barbieri E,Bazzoli F

    更新日期:2009-07-01 00:00:00

  • Recurrent diverticulitis.

    abstract::The term "diverticulitis" indicates the inflammation of a diverticulum or diverticula, which is accompanied by detectable or microscopical perforation. Diverticulitis is a common condition with an estimated incidence of 25%. At present, elective sigmoid resection is recommended after 2 episodes of uncomplicated divert...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章,评审


    authors: Comparato G,Di Mario F,NDSG.

    更新日期:2008-11-01 00:00:00

  • Role of infectious agents in exacerbations of ulcerative colitis in India. A study of Clostridium difficile.

    abstract::Fifty patients with idiopathic ulcerative colitis--25 with acute exacerbation of the disease (Group I) and 25 in quiescent phase (Group II)--were studied. None of the patients had a history of recent exposure to antimicrobial drugs or hospitalization. Evidence of infection with protozoal and bacterial agents and/or pr...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章


    authors: Kochhar R,Ayyagari A,Goenka MK,Dhali GK,Aggarwal R,Mehta SK

    更新日期:1993-01-01 00:00:00

  • Inability to noninvasively diagnose gastric intestinal metaplasia in Hispanics or reverse the lesion with Helicobacter pylori eradication.

    abstract:BACKGROUND:Helicobacter pylori infection has been linked with the development of gastric adenocarcinoma and its precursor lesion, intestinal metaplasia (IM). The presence of gastric IM is not associated with symptoms, which makes identification of individuals with this lesion difficult. It is not clear whether eradicat...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章,多中心研究


    authors: Morales TG,Sampliner RE,Camargo E,Marquis S,Garewal HS,Fennerty MB

    更新日期:2001-05-01 00:00:00

  • Utility and standards in esophageal manometry.

    abstract::Esophageal manometry is a specialized procedure used to evaluate lower and upper esophageal sphincter pressure, esophageal body contraction amplitude, and peristaltic sequence. The procedure is clinically useful in evaluation of a patient with nonstructural dysphagia, unexplained or noncardiac chest pain, a compendium...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章,评审


    authors: Katz PO,Menin RA,Gideon RM

    更新日期:2008-05-01 00:00:00

  • Advances in Imaging of Diffuse Parenchymal Liver Disease.

    abstract::There are >1.5 billion people with chronic liver disease worldwide, causing liver diseases to be a significant global health issue. Diffuse parenchymal liver diseases, including hepatic steatosis, fibrosis, metabolic diseases, and hepatitis cause chronic liver injury and may progress to fibrosis and eventually hepatoc...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章


    authors: Ghadimi M,Habibabadi RR,Hazhirkarzar B,Shaghaghi M,Ameli S,Khoshpouri P,Ghasabeh MA,Gurakar A,Pawlik TM,Kamel IR

    更新日期:2020-09-01 00:00:00

  • Pathophysiology of Nonalcoholic Steatohepatitis.

    abstract::Nonalcoholic fatty liver disease (NAFLD) affects approximately 30% of adults and 20% of children in the United States. Nonalcoholic steatohepatitis (NASH) is its most severe histologic form and progresses to cirrhosis in 20% of these patients. Once developed, 30% to 40% of patients with NASH cirrhosis will experience ...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章


    authors: McCullough AJ

    更新日期:2006-03-01 00:00:00

  • Costs and risks in the management of patients with gastric acid hypersecretion.

    abstract:GOALS:To define both risks and costs of optimal care of patients with gastric acid hypersecretion. BACKGROUND:The management of Zollinger-Ellison syndrome and other gastric acid hypersecretory disorders remains challenging. The optimal strategy for follow-up including gastric acid analysis, laboratory studies, and end...

    journal_title:Journal of clinical gastroenterology

    pub_type: 临床试验,杂志文章


    authors: Hirschowitz BI,Fineberg N,Wilcox CM,Mohnen J,Worthington J

    更新日期:2010-01-01 00:00:00

  • Hyper-CK-emia in pediatric celiac disease: prevalence and clinical importance.

    abstract::Hyper-transaminasemia (HT) is a well-known laboratory sign of celiac disease (CD); however, hyper-creatine phosphokinase (CK)-emia (HCK) is not so familiar. As there are reported cases of myopathy associated CD in the literature, we aimed to investigate serum CK levels of children with CD. Newly diagnosed 126 children...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章


    authors: Selimoglu MA,Ertekin V,Altinkaynak S

    更新日期:2007-08-01 00:00:00

  • High frequency of genotype D and spontaneous hepatitis B virus genomic mutations among Haitians in a multiethnic North American population.

    abstract:GOALS/BACKGROUND:The importance of hepatitis B virus (HBV) genotype and mutations has been increasingly recognized. We aimed to determine HBV genotype, precore (PC), and basal core promoter region (BCP) mutations in a HBV multiethnic South Florida population. STUDY:Samples from 213 patients were tested for HBV-DNA usi...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章


    authors: Couto CA,Levy C,Morris CJ,Hill M,de Medina M,Sanborn MR,Cloherty GA,Schiff ER,Martin P

    更新日期:2013-01-01 00:00:00

  • Combined duodenal and colonic necrosis. An unusual sequela of caustic ingestion.

    abstract::Two unusual cases of liquid caustic ingestion that resulted in gangrene of the duodenum and adjacent colon, and burns of the esophagus, stomach, and pancreas are presented. The routine evaluation of the oropharynx, esophagus, and stomach after liquid caustic ingestion can seriously underestimate the extent of injury t...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章


    authors: Guth AA,Pachter HL,Albanese C,Kim U

    更新日期:1994-12-01 00:00:00

  • Diagnostic workup strategies for patients with HIV-related chronic diarrhea. What is the end result?

    abstract::The intensity of diagnostic workup of patients with human immunodeficiency virus (HIV)-related chronic diarrhea is controversial. In the ideal setting in which an enteric pathogen is detected with minimal evaluation (stool tests) and in which specific treatment clears the diarrhea, eradicates the pathogen, and improve...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章,评审


    authors: Rabeneck L

    更新日期:1993-04-01 00:00:00

  • Spectrum of ulcerative colitis in north India.

    abstract::We analyzed retrospectively the characteristics of 87 patients with ulcerative colitis seen in a tertiary care center in north India. Ulcerative colitis was diagnosed on the basis of clinical features, sigmoidoscopy, rectal biopsy, and exclusion of microbiological causes of colitis. Severe clinical disease was seen in...

    journal_title:Journal of clinical gastroenterology

    pub_type: 杂志文章


    authors: Duphare H,Misra SC,Patnaik PK,Mathur M,Tandon RK

    更新日期:1994-01-01 00:00:00