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1. Dysmetabolism, Diabetes and Clinical Outcomes in Patients Cured of Chronic Hepatitis C: A Real-Life Cohort Study

Author

Valenti, L, Pelusi, S, Aghemo, A, Gritti, S, Pasulo, L, Bianco, C, Iegri, C, Cologni, G, Degasperi, E, D'Ambrosio, R, del Poggio, P, Soria, A, Puoti, M, Carderi, I, Pigozzi, M, Carriero, C, Spinetti, A, Zuccaro, V, Memoli, M, Giorgini, A, Vigano, M, Rumi, M, Re, T, Spinelli, O, Colombo, M, Quirino, T, Menzaghi, B, Lorini, G, Pan, A, D'Arminio Monforte, A, Buscarini, E, Autolitano, A, Bonfanti, P, Terreni, N, Aimo, G, Mendeni, M, Prati, D, Lampertico, P, Fagiuoli, S, Valenti L., Pelusi S., Aghemo A., Gritti S., Pasulo L., Bianco C., Iegri C., Cologni G., Degasperi E., D'Ambrosio R., del Poggio P., Soria A., Puoti M., Carderi I., Pigozzi M. G., Carriero C., Spinetti A., Zuccaro V., Memoli M., Giorgini A., Vigano M., Rumi M. G., Re T., Spinelli O., Colombo M. C., Quirino T., Menzaghi B., Lorini G., Pan A., D'Arminio Monforte A., Buscarini E., Autolitano A., Bonfanti P., Terreni N., Aimo G., Mendeni M., Prati D., Lampertico P., Colombo M., Fagiuoli S., Valenti, L, Pelusi, S, Aghemo, A, Gritti, S, Pasulo, L, Bianco, C, Iegri, C, Cologni, G, Degasperi, E, D'Ambrosio, R, del Poggio, P, Soria, A, Puoti, M, Carderi, I, Pigozzi, M, Carriero, C, Spinetti, A, Zuccaro, V, Memoli, M, Giorgini, A, Vigano, M, Rumi, M, Re, T, Spinelli, O, Colombo, M, Quirino, T, Menzaghi, B, Lorini, G, Pan, A, D'Arminio Monforte, A, Buscarini, E, Autolitano, A, Bonfanti, P, Terreni, N, Aimo, G, Mendeni, M, Prati, D, Lampertico, P, Fagiuoli, S, Valenti L., Pelusi S., Aghemo A., Gritti S., Pasulo L., Bianco C., Iegri C., Cologni G., Degasperi E., D'Ambrosio R., del Poggio P., Soria A., Puoti M., Carderi I., Pigozzi M. G., Carriero C., Spinetti A., Zuccaro V., Memoli M., Giorgini A., Vigano M., Rumi M. G., Re T., Spinelli O., Colombo M. C., Quirino T., Menzaghi B., Lorini G., Pan A., D'Arminio Monforte A., Buscarini E., Autolitano A., Bonfanti P., Terreni N., Aimo G., Mendeni M., Prati D., Lampertico P., Colombo M., and Fagiuoli S.

Abstract

The aim of this study was to examine the impact of features of dysmetabolism on liver disease severity, evolution, and clinical outcomes in a real-life cohort of patients treated with direct acting antivirals for chronic hepatitis C virus (HCV) infection. To this end, we considered 7,007 patients treated between 2014 and 2018, 65.3% with advanced fibrosis, of whom 97.7% achieved viral eradication (NAVIGATORE-Lombardia registry). In a subset (n = 748), liver stiffness measurement (LSM) was available at baseline and follow-up. Higher body mass index (BMI; odds ratio [OR] 1.06 per kg/m2, 1.03-1.09) and diabetes (OR 2.01 [1.65-2.46]) were independently associated with advanced fibrosis at baseline, whereas statin use was protective (OR 0.46 [0.35-0.60]; P < 0.0001 for all). The impact of BMI was greater in those without diabetes (P = 0.003). Diabetes was independently associated with less pronounced LSM improvement after viral eradication (P = 0.001) and in patients with advanced fibrosis was an independent predictor of the most frequent clinical events, namely de novo hepatocellular carcinoma (HCC; hazard ratio [HR] 2.09 [1.20-3.63]; P = 0.009) and cardiovascular events (HR 2.73 [1.16-6.43]; P = 0.021). Metformin showed a protective association against HCC (HR 0.32 [0.11-0.96]; P = 0.043), which was confirmed after adjustment for propensity score (P = 0.038). Diabetes diagnosis further refined HCC prediction in patients with compensated advanced chronic liver disease at high baseline risk (P = 0.024). Conclusion: Metabolic comorbidities were associated with advanced liver fibrosis at baseline, whereas statins were protective. In patients with advanced fibrosis, diabetes increased the risk of de novo HCC and of cardiovascular events. Optimization of metabolic comorbidities treatment by a multi-disciplinary management approach may improve cardiovascular and possibly liver-related

Published
2022

2. Comparison of three therapeutic regimens for genotype-3 hepatitis C virus infection in a large real-life multicentre cohort

Author

Soria, A, Fava, M, Bernasconi, D, Lapadula, G, Colella, E, Valsecchi, M, Migliorino, G, D'Ambrosio, R, Landonio, S, Schiavini, M, Spinetti, A, Carriero, C, Degasperi, E, Cologni, G, Gatti, F, Vigano, P, Hasson, H, Uberti-Foppa, C, Pasulo, L, Baiguera, C, Rossotti, R, Vinci, M, Puoti, M, Giorgini, A, Menzaghi, B, Lombardi, A, Pan, A, Aghemo, A, Grossi, P, Boldizzoni, R, Colombo, S, Vigano, M, Rumi, M, Del Poggio, P, Valenti, L, Giglio, O, De Bona, A, d'Arminio Monforte, A, Colombo, A, Spinelli, O, Pigozzi, M, Molteni, C, Bonfanti, P, Terreni, N, Perini, P, Capretti, A, Bella, D, Liani, C, Polo, S, Aimo, G, Pagnucco, L, Bhoori, S, Centenaro, R, Graffeo, M, Ciaccio, A, Dionigi, E, Lazzaroni, S, Carderi, I, Di Marco, M, Rizzardini, G, Noventa, F, Lampertico, P, Fagiuoli, S, Soria A., Fava M., Bernasconi D. P., Lapadula G., Colella E., Valsecchi M. G., Migliorino G. M., D'Ambrosio R., Landonio S., Schiavini M., Spinetti A., Carriero C., Degasperi E., Cologni G., Gatti F., Vigano P., Hasson H., Uberti-Foppa C., Pasulo L., Baiguera C., Rossotti R., Vinci M., Puoti M., Giorgini A., Menzaghi B., Lombardi A., Pan A., Aghemo A., Grossi P. A., Boldizzoni R., Colombo S., Vigano M., Rumi M. G., Del Poggio P., Valenti L., Giglio O., De Bona A., d'Arminio Monforte A., Colombo A., Spinelli O., Pigozzi M. G., Molteni C., Bonfanti P., Terreni N., Perini P., Capretti A., Bella D., Liani C., Polo S., Aimo G., Pagnucco L., Bhoori S., Centenaro R., Graffeo M., Ciaccio A., Dionigi E., Lazzaroni S., Carderi I., Di Marco M., Rizzardini G., Noventa F., Lampertico P., Fagiuoli S., Soria, A, Fava, M, Bernasconi, D, Lapadula, G, Colella, E, Valsecchi, M, Migliorino, G, D'Ambrosio, R, Landonio, S, Schiavini, M, Spinetti, A, Carriero, C, Degasperi, E, Cologni, G, Gatti, F, Vigano, P, Hasson, H, Uberti-Foppa, C, Pasulo, L, Baiguera, C, Rossotti, R, Vinci, M, Puoti, M, Giorgini, A, Menzaghi, B, Lombardi, A, Pan, A, Aghemo, A, Grossi, P, Boldizzoni, R, Colombo, S, Vigano, M, Rumi, M, Del Poggio, P, Valenti, L, Giglio, O, De Bona, A, d'Arminio Monforte, A, Colombo, A, Spinelli, O, Pigozzi, M, Molteni, C, Bonfanti, P, Terreni, N, Perini, P, Capretti, A, Bella, D, Liani, C, Polo, S, Aimo, G, Pagnucco, L, Bhoori, S, Centenaro, R, Graffeo, M, Ciaccio, A, Dionigi, E, Lazzaroni, S, Carderi, I, Di Marco, M, Rizzardini, G, Noventa, F, Lampertico, P, Fagiuoli, S, Soria A., Fava M., Bernasconi D. P., Lapadula G., Colella E., Valsecchi M. G., Migliorino G. M., D'Ambrosio R., Landonio S., Schiavini M., Spinetti A., Carriero C., Degasperi E., Cologni G., Gatti F., Vigano P., Hasson H., Uberti-Foppa C., Pasulo L., Baiguera C., Rossotti R., Vinci M., Puoti M., Giorgini A., Menzaghi B., Lombardi A., Pan A., Aghemo A., Grossi P. A., Boldizzoni R., Colombo S., Vigano M., Rumi M. G., Del Poggio P., Valenti L., Giglio O., De Bona A., d'Arminio Monforte A., Colombo A., Spinelli O., Pigozzi M. G., Molteni C., Bonfanti P., Terreni N., Perini P., Capretti A., Bella D., Liani C., Polo S., Aimo G., Pagnucco L., Bhoori S., Centenaro R., Graffeo M., Ciaccio A., Dionigi E., Lazzaroni S., Carderi I., Di Marco M., Rizzardini G., Noventa F., Lampertico P., and Fagiuoli S.

Abstract

Background & Aims: In the direct-acting antiviral era, treatment of genotype-3 HCV (HCV-GT3) is still challenging. Real-life comparisons between recommended regimens, sofosbuvir (SOF)+daclatasvir (DAC), SOF/velpatasvir (VEL), glecaprevir/pibrentasvir (GLE/PIB), are scarce. We aimed at filling this data gap. Methods: Sustained virological response 12 weeks after treatment completion (SVR12) was assessed for all HCV-GT3 patients consecutively treated within the Lombardia web-based Navigatore HCV-Network; differences in SVR12 across regimens were evaluated by logistic regression. Results: Of the 2082 subjects with HCV-GT3, 1544 were evaluable for comparisons between regimens: SOF + DAC (1023, 66.2%), SOF/VEL (369, 23.9%), GLE/PIB (152, 9.8%). Patients treated with former regimens were more frequently male, cirrhotic, HIV-positive, pretreated, used ribavirin in their regimen, and had lower baseline HCV-RNA. SVR12 was similar across groups: 94.8% in SOF + DAC, 97.6% in SOF/VEL, 96.7% in GLE/PIB (P =.065). At univariate analysis, SVR12 was associated with female gender (97.9% vs 94.8%, P =.007) and lower median pretreatment Log10HCV-RNA (5.87 vs 6.20, P =.001). At multivariate logistic regression analysis, treatment with SOF/VEL was associated with a higher likelihood of SVR12 than SOF + DAC, but only in the absence of ribavirin (98% vs 90.3%). Female gender and lower pretreatment HCV-RNA were independently associated with SVR12. Conclusions: In a large real-life setting of HCV-GT3-infected patients with a high proportion of cirrhosis, the success rate was remarkable. The slight advantage of SOF/VEL on SOF + DAC was significant only without ribavirin. The current prescription shift towards novel regimens (ie SOF/VEL and GLE/PIB) in easier-to-treat patients allows ribavirin-free and shorter schedules without mining SVR12 in this <> genotype.

Published
2020

5. Portal vein thrombosis relevance on liver cirrhosis: Italian Venous Thrombotic Events Registry

Author

Violi, F, Corazza, R, Caldwell, S, Perticone, F, Gatta, A, Angelico, M, Farcomeni, A, Masotti, M, Napoleone, L, Vestri, A, Raparelli, V, Basili, S, Palasciano, G, D'Alitto, F, Palmieri, V, Santovito, D, Di Michele, D, Croce, G, Sacerdoti, D, Brocco, S, Fasolato, S, Cecchetto, L, Bombonato, G, Bertoni, M, Restuccia, R, Andreozzi, P, Liguori, L, Caroleo, B, Perticone, M, Staltari, O, Manfredini, R, De Giorgi, A, Averna, M, Giammanco, A, Granito, A, Pettinari, I, Marinelli, S, Bolondi, L, Falsetti, L, Salvi, A, Durante-Mangoni, E, Cesaro, F, Farinaro, V, Ragone, E, Morana, I, Andriulli, A, Ippolito, A, Iacobellis, A, Niro, G, Merla, A, Raimondo, G, Maimone, S, Cacciola, I, Varvara, D, Drenaggi, D, Staffolani, S, Picardi, A, Vespasiani-Gentilucci, U, Galati, G, Gallo, P, Davi, G, Schiavone, C, Santilli, F, Tana, C, Licata, A, Soresi, M, Bianchi, B, Carderi, I, Pinto, A, Tuttolomondo, A, Ferrari, G, Gresele, P, Fierro, T, Morelli, O, Laffi, G, Romanelli, R, Arena, U, Cristina, S, Gasbarrini, A, Gargovich, M, Zocco, Z, Riccardi, L, Ainora, M, Capeci, W, Martino, M, Lorenzo, N, Cavallo, M, Frugiuele, P, Greco, A, Pietrangelo, A, Ventura, P, Cuoghi, C, Marcacci, M, Serviddio, G, Vendemiale, G, Villani, R, Gargano, R, Vidili, G, Di Cesare, V, Masala, M, Delitala, G, Invernizzi, P, Di Minno, G, Tufano, A, Purrello, F, Privitera, G, Forgione, A, Curigliano, V, Senzolo, M, Rodriguez-Castro, K, Giannelli, G, Serra, C, Neri, S, Pignataro, P, Rizzetto, M, Debernardi, V, Svegliati, B, Bergamaschi, G, Costanzo, F, Angelico, F, Del Ben, M, Polimeni, L, Talerico, G, Proietti, M, Romiti, G, Ruscio, E, Toriello, F, Violi F., Corazza R. G., Caldwell S. H., Perticone F., Gatta A., Angelico M., Farcomeni A., Masotti M., Napoleone L., Vestri A., Raparelli V., Basili S., Palasciano G., D'Alitto F., Palmieri V. O., Santovito D., Di Michele D., Croce G., Sacerdoti D., Brocco S., Fasolato S., Cecchetto L., Bombonato G., Bertoni M., Restuccia R., Andreozzi P., Liguori L. M., Caroleo B., Perticone M., Staltari O., Manfredini R., De Giorgi A., Averna M., Giammanco A., Granito A., Pettinari I., Marinelli S., Bolondi L., Falsetti L., Salvi A., Durante-Mangoni E., Cesaro F., Farinaro V., Ragone E., Morana I., Andriulli A., Ippolito A., Iacobellis A., Niro G., Merla A., Raimondo G., Maimone S., Cacciola I., Varvara D., Drenaggi D., Staffolani S., Picardi A., Vespasiani-Gentilucci U., Galati G., Gallo P., Davi G., Schiavone C., Santilli F., Tana C., Licata A., Soresi M., Bianchi B. G., Carderi I., Pinto A., Tuttolomondo A., Ferrari G., Gresele P., Fierro T., Morelli O., Laffi G., Romanelli R. G., Arena U., Cristina S., Gasbarrini A., Gargovich M., Zocco Z. M., Riccardi L., Ainora M. E., Capeci W., Martino M. G., Lorenzo N., Cavallo M., Frugiuele P., Greco A., Pietrangelo A., Ventura P., Cuoghi C., Marcacci M., Serviddio G., Vendemiale G., Villani R., Gargano R., Vidili G., Di Cesare V., Masala M., Delitala G., Invernizzi P., Di Minno G., Tufano A., Purrello F., Privitera G., Forgione A., Curigliano V., Senzolo M., Rodriguez-Castro K. -I., Giannelli G., Serra C., Neri S., Pignataro P., Rizzetto M., Debernardi V. W., Svegliati B. G., Bergamaschi G., Costanzo F., Angelico F., Del Ben M., Polimeni L., Talerico G., Proietti M., Romiti G. F., Ruscio E., Toriello F., Violi, F, Corazza, R, Caldwell, S, Perticone, F, Gatta, A, Angelico, M, Farcomeni, A, Masotti, M, Napoleone, L, Vestri, A, Raparelli, V, Basili, S, Palasciano, G, D'Alitto, F, Palmieri, V, Santovito, D, Di Michele, D, Croce, G, Sacerdoti, D, Brocco, S, Fasolato, S, Cecchetto, L, Bombonato, G, Bertoni, M, Restuccia, R, Andreozzi, P, Liguori, L, Caroleo, B, Perticone, M, Staltari, O, Manfredini, R, De Giorgi, A, Averna, M, Giammanco, A, Granito, A, Pettinari, I, Marinelli, S, Bolondi, L, Falsetti, L, Salvi, A, Durante-Mangoni, E, Cesaro, F, Farinaro, V, Ragone, E, Morana, I, Andriulli, A, Ippolito, A, Iacobellis, A, Niro, G, Merla, A, Raimondo, G, Maimone, S, Cacciola, I, Varvara, D, Drenaggi, D, Staffolani, S, Picardi, A, Vespasiani-Gentilucci, U, Galati, G, Gallo, P, Davi, G, Schiavone, C, Santilli, F, Tana, C, Licata, A, Soresi, M, Bianchi, B, Carderi, I, Pinto, A, Tuttolomondo, A, Ferrari, G, Gresele, P, Fierro, T, Morelli, O, Laffi, G, Romanelli, R, Arena, U, Cristina, S, Gasbarrini, A, Gargovich, M, Zocco, Z, Riccardi, L, Ainora, M, Capeci, W, Martino, M, Lorenzo, N, Cavallo, M, Frugiuele, P, Greco, A, Pietrangelo, A, Ventura, P, Cuoghi, C, Marcacci, M, Serviddio, G, Vendemiale, G, Villani, R, Gargano, R, Vidili, G, Di Cesare, V, Masala, M, Delitala, G, Invernizzi, P, Di Minno, G, Tufano, A, Purrello, F, Privitera, G, Forgione, A, Curigliano, V, Senzolo, M, Rodriguez-Castro, K, Giannelli, G, Serra, C, Neri, S, Pignataro, P, Rizzetto, M, Debernardi, V, Svegliati, B, Bergamaschi, G, Costanzo, F, Angelico, F, Del Ben, M, Polimeni, L, Talerico, G, Proietti, M, Romiti, G, Ruscio, E, Toriello, F, Violi F., Corazza R. G., Caldwell S. H., Perticone F., Gatta A., Angelico M., Farcomeni A., Masotti M., Napoleone L., Vestri A., Raparelli V., Basili S., Palasciano G., D'Alitto F., Palmieri V. O., Santovito D., Di Michele D., Croce G., Sacerdoti D., Brocco S., Fasolato S., Cecchetto L., Bombonato G., Bertoni M., Restuccia R., Andreozzi P., Liguori L. M., Caroleo B., Perticone M., Staltari O., Manfredini R., De Giorgi A., Averna M., Giammanco A., Granito A., Pettinari I., Marinelli S., Bolondi L., Falsetti L., Salvi A., Durante-Mangoni E., Cesaro F., Farinaro V., Ragone E., Morana I., Andriulli A., Ippolito A., Iacobellis A., Niro G., Merla A., Raimondo G., Maimone S., Cacciola I., Varvara D., Drenaggi D., Staffolani S., Picardi A., Vespasiani-Gentilucci U., Galati G., Gallo P., Davi G., Schiavone C., Santilli F., Tana C., Licata A., Soresi M., Bianchi B. G., Carderi I., Pinto A., Tuttolomondo A., Ferrari G., Gresele P., Fierro T., Morelli O., Laffi G., Romanelli R. G., Arena U., Cristina S., Gasbarrini A., Gargovich M., Zocco Z. M., Riccardi L., Ainora M. E., Capeci W., Martino M. G., Lorenzo N., Cavallo M., Frugiuele P., Greco A., Pietrangelo A., Ventura P., Cuoghi C., Marcacci M., Serviddio G., Vendemiale G., Villani R., Gargano R., Vidili G., Di Cesare V., Masala M., Delitala G., Invernizzi P., Di Minno G., Tufano A., Purrello F., Privitera G., Forgione A., Curigliano V., Senzolo M., Rodriguez-Castro K. -I., Giannelli G., Serra C., Neri S., Pignataro P., Rizzetto M., Debernardi V. W., Svegliati B. G., Bergamaschi G., Costanzo F., Angelico F., Del Ben M., Polimeni L., Talerico G., Proietti M., Romiti G. F., Ruscio E., and Toriello F.

Abstract

Portal vein thrombosis may occur in cirrhosis; nevertheless, its prevalence, and predictors are still elusive. To investigate this issue, the Italian Society of Internal Medicine undertook the “Portal vein thrombosis Relevance On Liver cirrhosis: Italian Venous thrombotic Events Registry” (PRO-LIVER). This prospective multicenter study includes consecutive cirrhotic patients undergoing Doppler ultrasound examination of the portal area to evaluate the prevalence and incidence of portal vein thrombosis over a 2-year scheduled follow-up. Seven hundred and fifty-three (68 % men; 64 ± 12 years) patients were included in the present analysis. Fifty percent of the cases were cirrhotic outpatients. Viral (44 %) etiology was predominant. Around half of the patients had a mild-severity disease according to the Child–Pugh score; hepatocellular carcinoma was present in 20 %. The prevalence of ultrasound-detected portal vein thrombosis was 17 % (n = 126); it was asymptomatic in 43 % of the cases. Notably, more than half of the portal vein thrombosis patients (n = 81) were not treated with anticoagulant therapy. Logistic step-forward multivariate analysis demonstrated that previous portal vein thrombosis (p < 0.001), Child–Pugh Class B + C (p < 0.001), hepatocellular carcinoma (p = 0.01), previous upper gastrointestinal bleeding (p = 0.030) and older age (p = 0.012) were independently associated with portal vein thrombosis. Portal vein thrombosis is a frequent complication of cirrhosis, particularly in patients with moderate–severe liver failure. The apparent undertreatment of patients with portal vein thrombosis is a matter of concern and debate, which should be addressed by planning interventional trials especially with newer oral anticoagulants. Clinicaltrials.gov identifier NCT01470547.

Published
2016

6. Portal Vein Thrombosis Relevance on Liver Cirrhosis: Italian Venous Thrombotic Events Registry

Author

Violi F., Corazza R. G., Caldwell S. H., Perticone F., Gatta A., Angelico M., Farcomeni A., Masotti M., Napoleone L., Vestri A., Raparelli V., Basili S., Palasciano G., D'Alitto F., Palmieri V. O., Santovito D., Di Michele D., Croce G., Sacerdoti D., Brocco S., Fasolato S., Cecchetto L., Bombonato G., Bertoni M., Restuccia R., Andreozzi P., Liguori L. M., Caroleo B., Perticone M., Staltari O., Manfredini R., De Giorgi A., Averna M., Giammanco A., Granito A., Pettinari I., Marinelli S., Bolondi L., Falsetti L., Salvi A., Durante-Mangoni E., Cesaro F., Farinaro V., Ragone E., Morana I., Andriulli A., Ippolito A., Iacobellis A., Niro G., Merla A., Raimondo G., Maimone S., Cacciola I., Varvara D., Drenaggi D., Staffolani S., Picardi A., Vespasiani-Gentilucci U., Galati G., Gallo P., Davi G., Schiavone C., Santilli F., Tana C., Licata A., Soresi M., Bianchi B. G., Carderi I., Pinto A., Tuttolomondo A., Ferrari G., Gresele P., Fierro T., Morelli O., Laffi G., Romanelli R. G., Arena U., Cristina S., Gasbarrini A., Gargovich M., Zocco Z. M., Riccardi L., Ainora M. E., Capeci W., Martino M. G., Lorenzo N., Cavallo M., Frugiuele P., Greco A., Pietrangelo A., Ventura P., Cuoghi C., Marcacci M., Serviddio G., Vendemiale G., Villani R., Gargano R., Vidili G., Di Cesare V., Masala M., Delitala G., Invernizzi P., Di Minno G., Tufano A., Purrello F., Privitera G., Forgione A., Curigliano V., Senzolo M., Rodriguez-Castro K. -I., Giannelli G., Serra C., Neri S., Pignataro P., Rizzetto M., Debernardi V. W., Svegliati B. G., Bergamaschi G., Costanzo F., Angelico F., Del Ben M., Polimeni L., Talerico G., Proietti M., Romiti G. F., Ruscio E., Toriello F., Violi, F., Corazza, R. G., Caldwell, S. H., Perticone, F., Gatta, A., Angelico, M., Farcomeni, A., Masotti, M., Napoleone, L., Vestri, A., Raparelli, V., Basili, S., Palasciano, G., D'Alitto, F., Palmieri, V. O., Santovito, D., Croce, G., Sacerdoti, D., Brocco, S., Fasolato, S., Cecchetto, L., Bombonato, G., Restuccia, R., Andreozzi, P., Liguori, L. M., Perticone, M., Staltari, O., Manfredini, R., De Giorgi, A., Averna, M., Giammanco, A., Granito, A., Marinelli, S., Bolondi, L., Falsetti, L., Salvi, A., Durante-Mangoni, E., Cesaro, F., Farinaro, V., Ragone, E., Morana, I., Andriulli, A., Ippolito, A., Iacobellis, A., Niro, G., Merla, A., Raimondo, G., Maimone, S., Cacciola, I., Varvara, D., Drenaggi, D., Staffolani, S., Picardi, A., Vespasiani-Gentilucci, U., Galati, G., Gallo, P., Davi, G., Schiavone, C., Santilli, F., Tana, C., Licata, A., Soresi, M., Bianchi, B. G., Carderi, I., Pinto, A., Tuttolomondo, A., Ferrari, G., Gresele, P., Fierro, T., Morelli, O., Laffi, G., Romanelli, R. G., Arena, U., Cristina, S., Gasbarrini, A., Gargovich, M., Zocco, Z. M., Riccardi, L., Ainora, M. E., Capeci, W., Martino, M. G., Lorenzo, N., Cavallo, M., Frugiuele, P., Greco, A., Pietrangelo, A., Ventura, P., Cuoghi, C., Marcacci, M., Serviddio, G., Vendemiale, G., Villani, R., Gargano, R., Vidili, G., Di Cesare, V., Masala, M., Delitala, G., Invernizzi, P., Di Minno, G., Tufano, A., Purrello, F., Privitera, G., Forgione, A., Curigliano, V., Senzolo, M., Rodriguez-Castro, K. -I., Giannelli, G., Serra, C., Neri, S., Pignataro, P., Rizzetto, M., Debernardi, V. W., Svegliati, B. G., Bergamaschi, G., Costanzo, F., Angelico, F., Del Ben, M., Polimeni, L., Talerico, G., Proietti, M., Romiti, G. F., Ruscio, E., Toriello, F., Violi, F, Corazza, R, Caldwell, S, Perticone, F, Gatta, A, Angelico, M, Farcomeni, A, Masotti, M, Napoleone, L, Vestri, A, Raparelli, V, Basili, S, Palasciano, G, D'Alitto, F, Palmieri, V, Santovito, D, Di Michele, D, Croce, G, Sacerdoti, D, Brocco, S, Fasolato, S, Cecchetto, L, Bombonato, G, Bertoni, M, Restuccia, R, Andreozzi, P, Liguori, L, Caroleo, B, Perticone, M, Staltari, O, Manfredini, R, De Giorgi, A, Averna, M, Giammanco, A, Granito, A, Pettinari, I, Marinelli, S, Bolondi, L, Falsetti, L, Salvi, A, Durante-Mangoni, E, Cesaro, F, Farinaro, V, Ragone, E, Morana, I, Andriulli, A, Ippolito, A, Iacobellis, A, Niro, G, Merla, A, Raimondo, G, Maimone, S, Cacciola, I, Varvara, D, Drenaggi, D, Staffolani, S, Picardi, A, Vespasiani-Gentilucci, U, Galati, G, Gallo, P, Davi, G, Schiavone, C, Santilli, F, Tana, C, Licata, A, Soresi, M, Bianchi, B, Carderi, I, Pinto, A, Tuttolomondo, A, Ferrari, G, Gresele, P, Fierro, T, Morelli, O, Laffi, G, Romanelli, R, Arena, U, Cristina, S, Gasbarrini, A, Gargovich, M, Zocco, Z, Riccardi, L, Ainora, M, Capeci, W, Martino, M, Lorenzo, N, Cavallo, M, Frugiuele, P, Greco, A, Pietrangelo, A, Ventura, P, Cuoghi, C, Marcacci, M, Serviddio, G, Vendemiale, G, Villani, R, Gargano, R, Vidili, G, Di Cesare, V, Masala, M, Delitala, G, Invernizzi, P, Di Minno, G, Tufano, A, Purrello, F, Privitera, G, Forgione, A, Curigliano, V, Senzolo, M, Rodriguez-Castro, K, Giannelli, G, Serra, C, Neri, S, Pignataro, P, Rizzetto, M, Debernardi, V, Svegliati, B, Bergamaschi, G, Costanzo, F, Angelico, F, Del Ben, M, Polimeni, L, Talerico, G, Proietti, M, Romiti, G, Ruscio, E, Toriello, F, Violi F., Corazza R.G., Caldwell S.H., Perticone F., Gatta A., Angelico M., Farcomeni A., Masotti M., Napoleone L., Vestri A., Raparelli V., Basili S., Palasciano G., D'Alitto F., Palmieri V.O., Santovito D., Di Michele D., Croce G., Sacerdoti D., Brocco S., Fasolato S., Cecchetto L., Bombonato G., Bertoni M., Restuccia R., Andreozzi P., Liguori L.M., Caroleo B., Perticone M., Staltari O., Manfredini R., De Giorgi A., Averna M., Giammanco A., Granito A., Pettinari I., Marinelli S., Bolondi L., Falsetti L., Salvi A., Durante-Mangoni E., Cesaro F., Farinaro V., Ragone E., Morana I., Andriulli A., Ippolito A., Iacobellis A., Niro G., Merla A., Raimondo G., Maimone S., Cacciola I., Varvara D., Drenaggi D., Staffolani S., Picardi A., Vespasiani-Gentilucci U., Galati G., Gallo P., Davi G., Schiavone C., Santilli F., Tana C., Licata A., Soresi M., Bianchi B.G., Carderi I., Pinto A., Tuttolomondo A., Ferrari G., Gresele P., Fierro T., Morelli O., Laffi G., Romanelli R.G., Arena U., Cristina S., Gasbarrini A., Gargovich M., Zocco Z.M., Riccardi L., Ainora M.E., Capeci W., Martino M.G., Lorenzo N., Cavallo M., Frugiuele P., Greco A., Pietrangelo A., Ventura P., Cuoghi C., Marcacci M., Serviddio G., Vendemiale G., Villani R., Gargano R., Vidili G., Di Cesare V., Masala M., Delitala G., Invernizzi P., Di Minno G., Tufano A., Purrello F., Privitera G., Forgione A., Curigliano V., Senzolo M., Rodriguez-Castro K.-I., Giannelli G., Serra C., Neri S., Pignataro P., Rizzetto M., Debernardi V.W., Svegliati B.G., Bergamaschi G., Costanzo F., Angelico F., Del Ben M., Polimeni L., Talerico G., Proietti M., Romiti G.F., Ruscio E., and Toriello F.

Subjects
Registrie, Liver Cirrhosis, Male, Cirrhosis, Hepatocellular carcinoma, 030204 cardiovascular system & hematology, Gastroenterology, 0302 clinical medicine, Esophageal varices, Prevalence, Medicine, Prospective Studies, Registries, Prospective cohort study, Multivariate Analysi, Venous Thrombosis, Portal Vein, Anticoagulants, Liver failure, Splanchnic venous thrombosis, Emergency Medicine, Internal Medicine, Middle Aged, Portal vein thrombosis, Venous thrombosis, Splanchnic venous thrombosis , Anticoagulants , Liver failure , Hepatocellular carcinoma , Esophageal varices, Italy, Liver, Female, 030211 gastroenterology & hepatology, medicine.symptom, Settore SECS-S/01 - Statistica, Human, medicine.medical_specialty, Liver Cirrhosi, Socio-culturale, Asymptomatic, 03 medical and health sciences, Anticoagulants, Esophageal varices, Hepatocellular carcinoma, Liver failure, Splanchnic venous thrombosis, Internal medicine, Humans, Aged, Hepatology, Esophageal varice, business.industry, Anticoagulant, Splanchnic venous thrombosi, medicine.disease, Surgery, Prospective Studie, Splanchnic venous thrombosis, Anticoagulants, Liver failure, Hepatocellular carcinoma, Esophageal varices, Multivariate Analysis, Upper gastrointestinal bleeding, Complication, business
Abstract

Portal vein thrombosis may occur in cirrhosis; nevertheless, its prevalence, and predictors are still elusive. To investigate this issue, the Italian Society of Internal Medicine undertook the “Portal vein thrombosis Relevance On Liver cirrhosis: Italian Venous thrombotic Events Registry” (PRO-LIVER). This prospective multicenter study includes consecutive cirrhotic patients undergoing Doppler ultrasound examination of the portal area to evaluate the prevalence and incidence of portal vein thrombosis over a 2-year scheduled follow-up. Seven hundred and fifty-three (68% men; 64±12years) patients were included in the present analysis. Fifty percent of the cases were cirrhotic outpatients. Viral (44%) etiology was predominant. Around half of the patients had a mild-severity disease according to the Child–Pugh score; hepatocellular carcinoma was present in 20%. The prevalence of ultrasound-detected portal vein thrombosis was 17% (n=126); it was asymptomatic in 43% of the cases. Notably, more than half of the portal vein thrombosis patients (n=81) were not treated with anticoagulant therapy. Logistic step-forward multivariate analysis demonstrated that previous portal vein thrombosis (p&nbsp

Published
2016
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7. Comparison of three therapeutic regimens for genotype-3 hepatitis C virus infection in a large real-life multicentre cohort

Author

Sergio Lazzaroni, Paolo Grossi, Chiara Molteni, Maria Grazia Valsecchi, Pietro Lampertico, Luca Valenti, Alessio Aghemo, Alessia Giorgini, Antonella d'Arminio Monforte, Roberta D'Ambrosio, Federico Gatti, Omar Giglio, Daniele Bella, Davide Paolo Bernasconi, Giuseppe Lapadula, Sherrie Bhoori, Hamid Hasson, Monica Schiavini, Elisa Colella, Roberto Boldizzoni, A. Ciaccio, Simona Landonio, Andrea Capretti, Maria Cristina Vinci, Giuliano Rizzardini, Barbara Menzaghi, Elisabetta Degasperi, Caterina Uberti-Foppa, Chiara Baiguera, Andrea Lombardi, Gianpiero Aimo, Layla Pagnucco, Paolo Perini, Giuliana Cologni, Natalia Terreni, Paolo Bonfanti, Mauro Viganò, Paolo Viganò, Alessandro Soria, Roberto Rossotti, Massimo Puoti, Ombretta Spinelli, Canio Carriero, Silvia Polo, Guglielmo Marco Migliorino, Silvia Colombo, Riccardo Centenaro, Luisa Pasulo, Anna De Bona, E. Dionigi, Paolo Poggio, Franco Noventa, Isabella Carderi, Angelo Pan, Angiola Spinetti, Mariella Di Marco, Cecilia Liani, Stefano Fagiuoli, Marie Graciella Pigozzi, Marco Fava, Massimo Graffeo, Maria Grazia Rumi, Alberto Colombo, Soria, A., Fava, M., Bernasconi, D. P., Lapadula, G., Colella, E., Valsecchi, M. G., Migliorino, G. M., D'Ambrosio, R., Landonio, S., Schiavini, M., Spinetti, A., Carriero, C., Degasperi, E., Cologni, G., Gatti, F., Vigano, P., Hasson, H., Uberti-Foppa, C., Pasulo, L., Baiguera, C., Rossotti, R., Vinci, M., Puoti, M., Giorgini, A., Menzaghi, B., Lombardi, A., Pan, A., Aghemo, A., Grossi, P. A., Boldizzoni, R., Colombo, S., Vigano, M., Rumi, M. G., Del Poggio, P., Valenti, L., Giglio, O., De Bona, A., d'Arminio Monforte, A., Colombo, A., Spinelli, O., Pigozzi, M. G., Molteni, C., Bonfanti, P., Terreni, N., Perini, P., Capretti, A., Bella, D., Liani, C., Polo, S., Aimo, G., Pagnucco, L., Bhoori, S., Centenaro, R., Graffeo, M., Ciaccio, A., Dionigi, E., Lazzaroni, S., Carderi, I., Di Marco, M., Rizzardini, G., Noventa, F., Lampertico, P., Fagiuoli, S., Soria, A, Fava, M, Bernasconi, D, Lapadula, G, Colella, E, Valsecchi, M, Migliorino, G, D'Ambrosio, R, Landonio, S, Schiavini, M, Spinetti, A, Carriero, C, Degasperi, E, Cologni, G, Gatti, F, Vigano, P, Hasson, H, Uberti-Foppa, C, Pasulo, L, Baiguera, C, Rossotti, R, Vinci, M, Puoti, M, Giorgini, A, Menzaghi, B, Lombardi, A, Pan, A, Aghemo, A, Grossi, P, Boldizzoni, R, Colombo, S, Vigano, M, Rumi, M, Del Poggio, P, Valenti, L, Giglio, O, De Bona, A, d'Arminio Monforte, A, Colombo, A, Spinelli, O, Pigozzi, M, Molteni, C, Bonfanti, P, Terreni, N, Perini, P, Capretti, A, Bella, D, Liani, C, Polo, S, Aimo, G, Pagnucco, L, Bhoori, S, Centenaro, R, Graffeo, M, Ciaccio, A, Dionigi, E, Lazzaroni, S, Carderi, I, Di Marco, M, Rizzardini, G, Noventa, F, Lampertico, P, and Fagiuoli, S

Subjects
Male, medicine.medical_specialty, Daclatasvir, Genotype, Sofosbuvir, ribavirin, pibrentasvir, daclatasvir, genotype 3, glecaprevir, Hepatitis C, sofosbuvir, sustained virological response, velpatasvir, Hepacivirus, Antiviral Agents, Gastroenterology, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Internal medicine, Ribavirin, medicine, Humans, Univariate analysis, Hepatology, business.industry, Glecaprevir, Hepatitis C, Chronic, medicine.disease, Pibrentasvir, Regimen, Treatment Outcome, chemistry, 030220 oncology & carcinogenesis, Drug Therapy, Combination, Female, 030211 gastroenterology & hepatology, business, medicine.drug
Abstract

Background & Aims: In the direct-acting antiviral era, treatment of genotype-3 HCV (HCV-GT3) is still challenging. Real-life comparisons between recommended regimens, sofosbuvir (SOF)+daclatasvir (DAC), SOF/velpatasvir (VEL), glecaprevir/pibrentasvir (GLE/PIB), are scarce. We aimed at filling this data gap. Methods: Sustained virological response 12weeks after treatment completion (SVR12) was assessed for all HCV-GT3 patients consecutively treated within the Lombardia web-based Navigatore HCV-Network; differences in SVR12 across regimens were evaluated by logistic regression. Results: Of the 2082 subjects with HCV-GT3, 1544 were evaluable for comparisons between regimens: SOF+DAC (1023, 66.2%), SOF/VEL (369, 23.9%), GLE/PIB (152, 9.8%). Patients treated with former regimens were more frequently male, cirrhotic, HIV-positive, pretreated, used ribavirin in their regimen, and had lower baseline HCV-RNA. SVR12 was similar across groups: 94.8% in SOF+DAC, 97.6% in SOF/VEL, 96.7% in GLE/PIB (P=.065). At univariate analysis, SVR12 was associated with female gender (97.9% vs 94.8%, P=.007) and lower median pretreatment Log10HCV-RNA (5.87 vs 6.20, P=.001). At multivariate logistic regression analysis, treatment with SOF/VEL was associated with a higher likelihood of SVR12 than SOF+DAC, but only in the absence of ribavirin (98% vs 90.3%). Female gender and lower pretreatment HCV-RNA were independently associated with SVR12. Conclusions: In a large real-life setting of HCV-GT3-infected patients with a high proportion of cirrhosis, the success rate was remarkable. The slight advantage of SOF/VEL on SOF+DAC was significant only without ribavirin. The current prescription shift towards novel regimens (ie SOF/VEL and GLE/PIB) in easier-to-treat patients allows ribavirin-free and shorter schedules without mining SVR12 in this <> genotype.

Published
2020

8. Platelet count does not predict bleeding in cirrhotic patients: Results from the PRO-LIVER Study

Author

Basili, S. a, Raparelli, V. b., Napoleone, L. b., Talerico, G. a., Corazza, G. R. c., Perticone, F. d., Sacerdoti, D. e., Andriulli, A. f., Licata, A. g., Pietrangelo, A., Picardi, A. i., Raimondo, G. j., Violi, F., Palasciano, G., D’Alitto, F., Palmieri, V. O., Santovito, D., Michele, Di, Croce, D., Brocco, G., Fasolato, S., Cecchetto, S., Bombonato, L., Bertoni, G., Restuccia, M., Andreozzi, T., Liguori, P., Caroleo, M. L., Perticone, B., Staltari, M., Manfredini, O., Giorgi, De, Averna, A., Giammanco, M., Granito, A., Pettinari, A., Marinelli, I., Bolondi, S., Falsetti, L., Salvi, L., Durante-Mangoni, A., Cesaro, E., Farinaro, F., Ragone, V., Morana, E., Ippolito, I., Iacobellis, A., Niro, A., Merla, G., Maimone, A., Cacciola, S., Varvara, I., Drenaggi, D., Staffolani, D., Vespasiani-Gentilucci, S., Galati, U., Gallo, G., Davì, P., Schiavone, G., Santilli, C., Tana, F., Soresi, C., Bianchi, Giovanni, Carderi, B., Pinto, I., Tuttolomondo, A., Ferrari, A., Gresele, G., Fierro, P., Morelli, T., Laffi, O., Romanelli, G., Arena, R. G., Stasi, U., Gasbarrini, A., Garcovich, M., Zocco, M. A., Riccardi, L., Ainora, M. E., Capeci, W., Martino, Giuseppe, Nobili, P., Cavallo, L., Frugiuele, M., Greco, P., Ventura, P., Cuoghi, C., Marcacci, M., Serviddio, G., Vendemiale, G., Villani, R., Gargano, R., Vidili, G., Cesare, Di, Masala, V., Delitala, M., Invernizzi, G., Vincenzo, P., Minno, Di, Tufano, G., Purrello, A., Privitera, F., Forgione, G., Curigliano, A., Senzolo, V., Rodríguez-Castro, M., Giannelli, K. I., Serra, G., Neri, C., Pignataro, S., Rizzetto, P., Debernardi, M., Svegliati, V. W., Bergamaschi, B. G., Masotti, G., Costanzo, M., Antonio, F., Angelico, F., Del, Ben, Polimeni, M., Proietti, L., Cangemi, M., Romiti, R., Toriello, G. F., Sperduti, F., Santangelo, N., Visioli, G., Todisco, G., Vestri, Anna, Farcomeni, R., Corrao, A., Gobbi, S., Corradini, E., Costantino, G., Tripepi, G., Angelico, M., Bolondi, L., D’Amico, G., Franchis, De, Gatta, R., Tassone, A., Anzaldi, E. J., Barone, M., Bazzini, M., Bianchi, C., Boari, P. I., Bracco, B., Buonauro, C., Buttà, A., Buzzetti, E., Calabria, S., Caradio, F., Carleo, P., Carrabba, Maria, Castorani, D., Cecchetto, L., Cicco, L., Cimini, S., Colombo, C., B. M., Vuono, De, Denegri, S., Del, Corso, Giosia, Di, Donnarumma, P., Giorgini, E., Grassi, P., Grembiale, D., Hijazi, A., Iamele, D., Lorusso, L., Marchese, G., Marra, Alberto, Masala, M., Miceli, M., Montebianco, G., Murgia, A. L., Naccarato, G., Padula, P., Pattoneri, D., Perego, P., Pesce, F., Petramala, P., Piano, L., Pinto, S., Pinna, D., Pignataro, M., Pretti, F. S., Pucci, V., Salinaro, G., Salzano, F., Santarossa, A., Scarpini, C., Scicali, F., Sirico, R., Suppressa, D., Talia, P., Torres, M., Traversa, D., Vazzana, M., Vecchio, Claudia, Vettore, R., Vitale, E., Basili, S., Raparelli, V., Napoleone, L., Talerico, G., Corazza, G.R., Perticone, F., Sacerdoti, D., Andriulli, A., Licata, A., Pietrangelo, A., Picardi, A., Raimondo, G., Violi, F., Palasciano, Giuseppe, D’Alitto, Felicia, Palmieri, Vincenzo Ostilio, Santovito, Daniela, Di Michele, Dario, Croce, Giuseppe, Brocco, Silvia, Fasolato, Silvano, Cecchetto, Lara, Bombonato, Giancarlo, Bertoni, Michele, Restuccia, Tea, Andreozzi, Paola, Liguori, Maria Livia, Caroleo, Benedetto, Perticone, Maria, Staltari, Orietta, Manfredini, Roberto, De Giorgi, Alfredo, Averna, Maurizio, Giammanco, Antonina, Granito, Alessandro, Pettinari, Irene, Marinelli, Sara, Bolondi, Luigi, Falsetti, Lorenzo, Salvi, Aldo, Durante-Mangoni, Emanuele, Cesaro, Flavio, Farinaro, Vincenza, Ragone, Enrico, Morana, Ignazio, Ippolito, Antonio, Iacobellis, Angelo, Niro, Grazia, Merla, Antonio, Maimone, Sergio, Cacciola, Irene, Varvara, Doriana, Drenaggi, Davide, Staffolani, Silvia, Vespasiani-Gentilucci, Umberto, Galati, Giovanni, Gallo, Paolo, Davì, Giovanni, Schiavone, Cosima, Santilli, Francesca, Tana, Claudio, Soresi, Maurizio, Bianchi Giovanni, Battista, Carderi, Isabella, Pinto, Antonio, Tuttolomondo, Antonino, Ferrari, Giovanni, Gresele, Paolo, Fierro, Tiziana, Morelli, Olivia, Laffi, Giacomo, Romanelli, Roberto Giulio, Arena, Umberto, Stasi, Cristina, Gasbarrini, Antonio, Garcovich, Matteo, Zocco, Maria Assunta, Riccardi, Laura, Ainora, Maria Elena, Capeci, William, Martino Giuseppe, Pio, Nobili, Lorenzo, Cavallo, Maurizio, Frugiuele, Pierluigi, Greco, Antonio, Ventura, Paolo, Cuoghi, Chiara, Marcacci, Matteo, Serviddio, Gaetano, Vendemiale, Gianluigi, Villani, Rosanna, Gargano, Ruggiero, Vidili, Gianpaolo, Di Cesare, Valentina, Masala, Maristella, Delitala, Giuseppe, Invernizzi, Pietro, Vincenzo, Ronca, Di Minno, Giovanni, Tufano, Antonella, Purrello, Francesco, Privitera, Graziella, Forgione, Alessandra, Curigliano, Valentina, Senzolo, Marco, Rodríguez-Castro, Kryssia Isabel, Giannelli, Gianluigi, Serra, Carla, Neri, Sergio, Pignataro, Pietro, Rizzetto, Mario, Debernardi, Venon Wilma, Svegliati, Baroni Gianluca, Bergamaschi, Gaetano, Masotti, Michela, Costanzo, Filippo, Antonio, Figliomeni, Angelico, Francesco, Del Ben, Maria, Polimeni, Licia, Proietti, Marco, Cangemi, Roberto, Romiti Giulio, Francesco, Toriello, Filippo, Sperduti, Nicolò, Santangelo, Giuseppe, Visioli, Giacomo, Todisco, Tommaso, Vestri Anna, Rita, Farcomeni, Alessio, Corrao, Salvatore, Gobbi, Paolo, Corradini, Elena, Costantino, Giorgio, Tripepi, Giovanni, Angelico, Mario, D’Amico, Gennaro, De Franchis, Roberto, Gatta, Angelo, Tassone, Eliezer Joseph, Anzaldi, Massimiliano, Barone, Milena, Bazzini, Cristina, Bianchi, Paola Ilaria, Boari, Benedetta, Bracco, Christian, Buonauro, Agostino, Buttà, Carmelo, Buzzetti, Elena, Calabria, Stefano, Caradio, Federica, Carleo, Pietro, Carrabba Maria, Domenica, Castorani, Luigi, Cicco, Sebastiano, Cimini, Claudia, Colombo, Barbara Maria, De Vuono, Stefano, Denegri, Andrea, Del Corso, Lisette, Di Giosia, Paolo, Donnarumma, Emilia, Giorgini, Paolo, Grassi, Davide, Grembiale, Alessandro, Hijazi, Daniel, Iamele, Luigi, Lorusso, Giusi, Marchese, Alessandra, Marra Alberto, Maria, Miceli, Giuseppe, Montebianco, Abenavoli Ludovico, Murgia, Giuseppe, Naccarato, Paola, Padula, Donatella, Pattoneri, Paolo, Perego, Francesca, Pesce, Paola, Petramala, Luigi, Piano, Salvatore, Pinto, Daniela, Pinna, Miriam, Pignataro, Francesca Serena, Pretti, Vincenzo, Pucci, Giacomo, Salinaro, Francesco, Salzano, Andrea, Santarossa, Claudia, Scarpini, Francesca, Scicali, Roberto, Sirico, Domenico, Suppressa, Patrizia, Talia, Michela, Torres, Daniele, Traversa, Matteo, Vazzana, Natale, Vecchio Claudia, Rita, Vettore, Elia, Vitale, Francesco, Basili, S, Raparelli, V, Napoleone, L, Talerico, G, Corazza, G, Perticone, F, Sacerdoti, D, Andriulli, A, Licata, A, Pietrangelo, A, Picardi, A, Raimondo, G, Violi, F, Palasciano, G, D'Alitto, F, Palmieri, V, Santovito, D, Di Michele, D, Croce, G, Brocco, S, Fasolato, S, Cecchetto, L, Bombonato, G, Bertoni, M, Restuccia, T, Andreozzi, P, Liguori, M, Caroleo, B, Perticone, M, Staltari, O, Manfredini, R, De Giorgi, A, Averna, M, Giammanco, A, Granito, A, Pettinari, I, Marinelli, S, Bolondi, L, Falsetti, L, Salvi, A, Durante-Mangoni, E, Cesaro, F, Farinaro, V, Ragone, E, Morana, I, Ippolito, A, Iacobellis, A, Niro, G, Merla, A, Maimone, S, Cacciola, I, Varvara, D, Drenaggi, D, Staffolani, S, Vespasiani-Gentilucci, U, Galati, G, Gallo, P, Davi, G, Schiavone, C, Santilli, F, Tana, C, Soresi, M, Bianchi Giovanni, B, Carderi, I, Pinto, A, Tuttolomondo, A, Ferrari, G, Gresele, P, Fierro, T, Morelli, O, Laffi, G, Romanelli, R, Arena, U, Stasi, C, Gasbarrini, A, Garcovich, M, Zocco, M, Riccardi, L, Ainora, M, Capeci, W, Martino Giuseppe, P, Nobili, L, Cavallo, M, Frugiuele, P, Greco, A, Ventura, P, Cuoghi, C, Marcacci, M, Serviddio, G, Vendemiale, G, Villani, R, Gargano, R, Vidili, G, Di Cesare, V, Masala, M, Delitala, G, Invernizzi, P, Vincenzo, R, Di Minno, G, Tufano, A, Purrello, F, Privitera, G, Forgione, A, Curigliano, V, Senzolo, M, Rodriguez-Castro, K, Giannelli, G, Serra, C, Neri, S, Pignataro, P, Rizzetto, M, Debernardi, V, Svegliati, B, Bergamaschi, G, Masotti, M, Costanzo, F, Antonio, F, Angelico, F, Del Ben, M, Polimeni, L, Proietti, M, Cangemi, R, Romiti, G, Toriello, F, Sperduti, N, Santangelo, G, Visioli, G, Todisco, T, Vestri Anna, R, Farcomeni, A, Corrao, S, Gobbi, P, Corradini, E, Costantino, G, Tripepi, G, Angelico, M, D'Amico, G, De Franchis, R, Gatta, A, Tassone, E, Anzaldi, M, Barone, M, Bazzini, C, Bianchi, P, Boari, B, Bracco, C, Buonauro, A, Butta, C, Buzzetti, E, Calabria, S, Caradio, F, Carleo, P, Carrabba Maria, D, Castorani, L, Cicco, S, Cimini, C, Colombo, B, De Vuono, S, Denegri, A, Del Corso, L, Di Giosia, P, Donnarumma, E, Giorgini, P, Grassi, D, Grembiale, A, Hijazi, D, Iamele, L, Lorusso, G, Marchese, A, Marra, A, Miceli, G, Montebianco, A, Murgia, G, Naccarato, P, Padula, D, Pattoneri, P, Perego, F, Pesce, P, Petramala, L, Piano, S, Pinto, D, Pinna, M, Pignataro, F, Pretti, V, Pucci, G, Salinaro, F, Salzano, A, Santarossa, C, Scarpini, F, Scicali, R, Sirico, D, Suppressa, P, Talia, M, Torres, D, Traversa, M, Vazzana, N, Vecchio Claudia, R, Vettore, E, Vitale, F, S Basili, V Raparelli, L Napoleone, G Talerico, G Corazza, F Perticone, D Sacerdoti, A Andriulli, A Licata, A Pietrangelo, A Picardi, G Raimondo, F Violi, MD on behalf of PRO-LIVER Collaborator, Palasciano Giuseppe, D’Alitto Felicia, Palmieri Vincenzo Ostilio, Santovito Daniela, Di Michele Dario, Croce Giuseppe, Brocco Silvia, Fasolato Silvano, Cecchetto Lara, Bombonato Giancarlo, Bertoni Michele, Restuccia Tea, Andreozzi Paola, Liguori Maria Livia, Caroleo Benedetto, Perticone Maria, Staltari Orietta, Manfredini Roberto, De Giorgi Alfredo, Averna Maurizio, Giammanco Antonina, Granito Alessandro, Pettinari Irene, Marinelli Sara, Bolondi Luigi, Falsetti Lorenzo, Salvi Aldo, Durante-Mangoni Emanuele, Cesaro Flavio, Farinaro Vincenza, Ragone Enrico, Morana Ignazio, Ippolito Antonio, Iacobellis Angelo, Niro Grazia, Merla Antonio, Maimone Sergio, Cacciola Irene, Varvara Doriana, Drenaggi Davide, Staffolani Silvia, Vespasiani-Gentilucci Umberto, Galati Giovanni, Gallo Paolo, Davi Giovanni, Schiavone Cosima, Santilli Francesca, Tana Claudio, Soresi Maurizio, Bianchi Giovanni Battista, Carderi Isabella, Pinto Antonio, Tuttolomondo Antonino, Ferrari Giovanni, Gresele Paolo, Fierro Tiziana, Morelli Olivia, Laffi Giacomo, Romanelli Roberto Giulio, Arena Umberto, Stasi Cristina, Gasbarrini Antonio, Garcovich Matteo, Zocco Maria Assunta, Riccardi Laura, Ainora Maria Elena, Capeci William, Martino Giuseppe Pio, Nobili Lorenzo, Cavallo Maurizio, Frugiuele Pierluigi, Greco Antonio, Ventura Paolo, Cuoghi Chiara, Marcacci Matteo, Serviddio Gaetano, Vendemiale Gianluigi, Villani Rosanna, Gargano Ruggiero, Vidili Gianpaolo, Di Cesare Valentina, Masala Maristella, Delitala Giuseppe, Invernizzi Pietro, Vincenzo Ronca, Di Minno Giovanni, Tufano Antonella, Purrello Francesco, Privitera Graziella, Forgione Alessandra, Curigliano Valentina, Senzolo Marco, Rodríguez-Castro Kryssia Isabel, Giannelli Gianluigi, Serra Carla, Neri Sergio, Pignataro Pietro, Rizzetto Mario, Debernardi Venon Wilma, Svegliati Baroni Gianluca, Bergamaschi Gaetano, Masotti Michela, Costanzo Filippo, Antonio Figliomeni, Angelico Francesco, Del Ben Maria, Polimeni Licia, Proietti Marco, Cangemi Roberto, Romiti Giulio Francesco, Toriello Filippo, Sperduti Nicolò, Santangelo Giuseppe, Visioli Giacomo, Todisco Tommaso, Vestri Anna Rita, Farcomeni Alessio, Corrao Salvatore, Gobbi Paolo, Corradini Elena, Costantino Giorgio, Tripepi Giovanni, Angelico Mario, D’Amico Gennaro, de Franchis Roberto, Gatta Angelo, Tassone Eliezer Joseph, Anzaldi Massimiliano, Barone Milena, Bazzini Cristina, Bianchi Paola Ilaria, Boari Benedetta, Bracco Christian, Buonauro Agostino, Buttà Carmelo, Buzzetti Elena, Calabria Stefano, Caradio Federica, Carleo Pietro, Carrabba Maria Domenica, Castorani Luigi, Cicco Sebastiano, Cimini Claudia, Colombo Barbara Maria, De Vuono Stefano, Denegri Andrea, Del Corso Lisette, Di Giosia Paolo, Donnarumma Emilia, Giorgini Paolo, Grassi Davide, Grembiale Alessandro, Hijazi Daniel, Iamele Luigi, Lorusso Giusi, Marchese Alessandra, Marra Alberto Maria, Miceli Giuseppe, Montebianco Abenavoli Ludovico, Murgia Giuseppe, Naccarato Paola, Padula Donatella, Pattoneri Paolo, Perego Francesca, Pesce Paola, Petramala Luigi, Piano Salvatore, Pinto Daniela, Pinna Miriam, Pignataro Francesca Serena, Pretti Vincenzo, Pucci Giacomo, Salinaro Francesco, Salzano Andrea, Santarossa Claudia, Scarpini Francesca, Scicali Roberto, Sirico Domenico, Suppressa Patrizia, Talia Michela, Torres Daniele, Traversa Matteo, Vazzana Natale, Vecchio Claudia Rita, Vettore Elia, Vitale Francesco, Corazza, G. R., Guidacci, Raimondo, Palasciano, G., D'Alitto, F., Palmieri, V. O., Santovito, D., Di Michele, D., Croce, G., Brocco, S., Fasolato, S., Cecchetto, L., Bombonato, G., Bertoni, M., Restuccia, T., Andreozzi, P., Liguori, M. L., Caroleo, B., Perticone, M., Staltari, O., Manfredini, R., De Giorgi, A., Averna, M., Giammanco, A., Granito, A., Pettinari, I., Marinelli, S., Bolondi, L., Falsetti, L., Salvi, A., Durante-Mangoni, E., Cesaro, F., Farinaro, V., Ragone, E., Morana, I., Ippolito, A., Iacobellis, A., Niro, G., Merla, A., Maimone, S., Cacciola, I., Varvara, D., Drenaggi, D., Staffolani, S., Vespasiani-Gentilucci, U., Galati, G., Gallo, P., Davi, G., Schiavone, C., Santilli, F., Tana, C., Soresi, M., Bianchi Giovanni, B., Carderi, I., Pinto, A., Tuttolomondo, A., Ferrari, G., Gresele, P., Fierro, T., Morelli, O., Laffi, G., Romanelli, R. G., Arena, U., Stasi, C., Gasbarrini, A., Garcovich, M., Zocco, M. A., Riccardi, L., Ainora, M. E., Capeci, W., Martino Giuseppe, P., Nobili, L., Cavallo, M., Frugiuele, P., Greco, A., Ventura, P., Cuoghi, C., Marcacci, M., Serviddio, G., Vendemiale, G., Villani, R., Gargano, R., Vidili, G., Di Cesare, V., Masala, M., Delitala, G., Invernizzi, P., Vincenzo, R., Di Minno, G., Tufano, A., Purrello, F., Privitera, G., Forgione, A., Curigliano, V., Senzolo, M., Rodriguez-Castro, K. I., Giannelli, G., Serra, C., Neri, S., Pignataro, P., Rizzetto, M., Debernardi, V. W., Svegliati, B. G., Bergamaschi, G., Masotti, M., Costanzo, F., Antonio, F., Angelico, F., Del Ben, M., Polimeni, L., Proietti, M., Cangemi, R., Romiti, G. F., Toriello, F., Sperduti, N., Santangelo, G., Visioli, G., Todisco, T., Vestri Anna, R., Farcomeni, A., Corrao, S., Gobbi, P., Corradini, E., Costantino, G., Tripepi, G., Angelico, M., D'Amico, G., De Franchis, R., Gatta, A., Tassone, E. J., Anzaldi, M., Barone, M., Bazzini, C., Bianchi, P. I., Boari, B., Bracco, C., Buonauro, A., Butta, C., Buzzetti, E., Calabria, S., Caradio, F., Carleo, P., Carrabba Maria, D., Castorani, L., Cicco, S., Cimini, C., Colombo, B. M., De Vuono, S., Denegri, A., Del Corso, L., Di Giosia, P., Donnarumma, E., Giorgini, P., Grassi, D., Grembiale, A., Hijazi, D., Iamele, L., Lorusso, G., Marchese, A., Marra, A. M., Miceli, G., Montebianco, A. L., Murgia, G., Naccarato, P., Padula, D., Pattoneri, P., Perego, F., Pesce, P., Petramala, L., Piano, S., Pinto, D., Pinna, M., Pignataro, F. S., Pretti, V., Pucci, G., Salinaro, F., Salzano, A., Santarossa, C., Scarpini, F., Scicali, R., Sirico, D., Suppressa, P., Talia, M., Torres, D., Traversa, M., Vazzana, N., Vecchio Claudia, R., Vettore, E., and Vitale, F.

Subjects
Liver Cirrhosis, Male, Settore MED/09 - Medicina Interna, 030204 cardiovascular system & hematology, Gastroenterology, Severity of Illness Index, cjirrhosis, ACTIVATION, 0302 clinical medicine, Risk Factors, Medicine, Platelet, Prospective Studies, Prospective cohort study, RISK, Aged, 80 and over, medicine.diagnostic_test, PRO-LIVER, Platelet, cirrhosis, gastrointestinal bleeding, ASSOCIATION, Middle Aged, Prognosis, Italy, 030211 gastroenterology & hepatology, Female, Gastrointestinal Hemorrhage, Human, Adult, Platelets, medicine.medical_specialty, Prognosi, Liver Cirrhosi, MEDLINE, COAGULATION, gastrointestinal bleeding, Socio-culturale, Hemorrhage, Hepatology, Follow-Up Studie, 03 medical and health sciences, Text mining, Internal medicine, Severity of illness, ENDOTOXEMIA, Pro-Liver Study, Humans, HEMOSTASIS, International Normalized Ratio, Aged, Proportional Hazards Models, Prothrombin time, Cirrhosi, Platelet Count, Bleeding, Liver Cirrhosis, business.industry, Proportional hazards model, Platelet Count, Risk Factor, cirrhosis, bleeding, Thrombocytopenia, Prospective Studie, THROMBOSIS, Platelets, cjirrhosis, bleeding, PRO-LIVER, Proportional Hazards Model, Prothrombin Time, business, DECOMPENSATED CIRRHOSIS, Follow-Up Studies
Abstract

OBJECTIVES: Thrombocytopenia is a hallmark for patients with cirrhosis and it is perceived as a risk factor for bleeding events. However, the relationship between platelet count and bleeding is still unclear. METHODS: We investigated the relationship between platelet count and major or clinical relevant nonmajor bleedings during a follow-up of ∼4 years. RESULTS: A total of 280 cirrhotic patients with different degrees of liver disease (67% males; age 64±37 years; 47% Child–Pugh B and C) were followed up for a median of 1,129 (interquartile range: 800–1,498) days yielding 953.12 patient-year of observation. The annual rate of any significant bleeding was 5.45%/year (3.57%/year and 1.89%/year for major and minor bleeding, respectively). Fifty-two (18.6%) patients experienced a major (n=34) or minor (n=18) bleeding event, predominantly from gastrointestinal origin. Platelet counts progressively decreased with the worsening of liver disease and were similar in patients with or without major or minor bleeding: a platelet count ≤50×103/μl was detected in 3 (6%) patients with and in 20 (9%) patients without any bleeding event. Conversely, prothrombin time-international normalized ratio was slightly higher in patients with overall or major bleeding. On Cox proportional hazard analysis, only a previous gastrointestinal bleeding (hazard ratio (HR): 1.96; 95% confidence interval: 1.11–3.47; P=0.020) and encephalopathy (HR: 2.05; 95% confidence interval: 1.16–3.62; P=0.013) independently predicted overall bleeding events. CONCLUSIONS: Platelet count does not predict unprovoked major or minor bleeding in cirrhotic patients.

Published
2018

9. Dysmetabolism, Diabetes and Clinical Outcomes in Patients Cured of Chronic Hepatitis C: A Real-Life Cohort Study

Author

Gianpaolo Lorini, Roberta D'Ambrosio, Monia Mendeni, Angelo Pan, Valentina Zuccaro, Canio Carriero, Massimo Colombo, Gianpiero Aimo, Natalia Terreni, Barbara Menzaghi, Massimo Memoli, Alessandro Soria, Aldo Autolitano, Elisabetta Degasperi, Serena Pelusi, M. Puoti, Luca Valenti, Cristiana Bianco, Ombretta Spinelli, Elisabetta Buscarini, Antonella d'Arminio Monforte, Sara Gritti, Paolo Del Poggio, Alessia Giorgini, Tiziana Quirino, T. Re, Marie Graciella Pigozzi, Maria Grazia Rumi, Maria Chiara Colombo, Giuliana Cologni, Daniele Prati, Angiola Spinetti, Stefano Fagiuoli, Mauro Viganò, Isabella Carderi, Luisa Pasulo, Pietro Lampertico, Alessio Aghemo, Paolo Bonfanti, C. Iegri, Valenti, L, Pelusi, S, Aghemo, A, Gritti, S, Pasulo, L, Bianco, C, Iegri, C, Cologni, G, Degasperi, E, D'Ambrosio, R, del Poggio, P, Soria, A, Puoti, M, Carderi, I, Pigozzi, M, Carriero, C, Spinetti, A, Zuccaro, V, Memoli, M, Giorgini, A, Vigano, M, Rumi, M, Re, T, Spinelli, O, Colombo, M, Quirino, T, Menzaghi, B, Lorini, G, Pan, A, D'Arminio Monforte, A, Buscarini, E, Autolitano, A, Bonfanti, P, Terreni, N, Aimo, G, Mendeni, M, Prati, D, Lampertico, P, and Fagiuoli, S

Subjects
Liver Cirrhosis, medicine.medical_specialty, Carcinoma, Hepatocellular, Sustained Virologic Response, Chronic liver disease, Gastroenterology, Antiviral Agents, Cohort Studies, 03 medical and health sciences, Liver disease, 0302 clinical medicine, Internal medicine, Diabetes mellitus, Diabetes Mellitus, Medicine, Humans, 2. Zero hunger, Hepatology, business.industry, Hazard ratio, Liver Neoplasms, Odds ratio, Hepatitis C, Chronic, medicine.disease, 3. Good health, Metformin, Cardiovascular Diseases, 030220 oncology & carcinogenesis, Hepatocellular carcinoma, HCV, 030211 gastroenterology & hepatology, business, Body mass index, medicine.drug
Abstract

The aim of this study was to examine the impact of features of dysmetabolism on liver disease severity, evolution, and clinical outcomes in a real-life cohort of patients treated with direct acting antivirals for chronic hepatitis C virus (HCV) infection. To this end, we considered 7,007 patients treated between 2014 and 2018, 65.3% with advanced fibrosis, of whom 97.7% achieved viral eradication (NAVIGATORE-Lombardia registry). In a subset (n=748), liver stiffness measurement (LSM) was available at baseline and follow-up. Higher body mass index (BMI; odds ratio [OR] 1.06 per kg/m2, 1.03-1.09) and diabetes (OR 2.01 [1.65-2.46]) were independently associated with advanced fibrosis at baseline, whereas statin use was protective (OR 0.46 [0.35-0.60]; P&nbsp

Published
2021

10. Dysmetabolism, Diabetes and Clinical Outcomes in Patients Cured of Chronic Hepatitis C: A Real-Life Cohort Study.

Author

Valenti L, Pelusi S, Aghemo A, Gritti S, Pasulo L, Bianco C, Iegri C, Cologni G, Degasperi E, D'Ambrosio R, Del Poggio P, Soria A, Puoti M, Carderi I, Pigozzi MG, Carriero C, Spinetti A, Zuccaro V, Memoli M, Giorgini A, Viganò M, Rumi MG, Re T, Spinelli O, Colombo MC, Quirino T, Menzaghi B, Lorini G, Pan A, D'Arminio Monforte A, Buscarini E, Autolitano A, Bonfanti P, Terreni N, Aimo G, Mendeni M, Prati D, Lampertico P, Colombo M, and Fagiuoli S

Subjects
Antiviral Agents therapeutic use, Cohort Studies, Humans, Liver Cirrhosis diagnosis, Sustained Virologic Response, Carcinoma, Hepatocellular epidemiology, Cardiovascular Diseases complications, Diabetes Mellitus drug therapy, Hepatitis C, Chronic complications, Liver Neoplasms epidemiology
Abstract

The aim of this study was to examine the impact of features of dysmetabolism on liver disease severity, evolution, and clinical outcomes in a real-life cohort of patients treated with direct acting antivirals for chronic hepatitis C virus (HCV) infection. To this end, we considered 7,007 patients treated between 2014 and 2018, 65.3% with advanced fibrosis, of whom 97.7% achieved viral eradication (NAVIGATORE-Lombardia registry). In a subset (n = 748), liver stiffness measurement (LSM) was available at baseline and follow-up. Higher body mass index (BMI; odds ratio [OR] 1.06 per kg/m 2 , 1.03-1.09) and diabetes (OR 2.01 [1.65-2.46]) were independently associated with advanced fibrosis at baseline, whereas statin use was protective (OR 0.46 [0.35-0.60]; P < 0.0001 for all). The impact of BMI was greater in those without diabetes (P = 0.003). Diabetes was independently associated with less pronounced LSM improvement after viral eradication (P = 0.001) and in patients with advanced fibrosis was an independent predictor of the most frequent clinical events, namely de novo hepatocellular carcinoma (HCC; hazard ratio [HR] 2.09 [1.20-3.63]; P = 0.009) and cardiovascular events (HR 2.73 [1.16-6.43]; P = 0.021). Metformin showed a protective association against HCC (HR 0.32 [0.11-0.96]; P = 0.043), which was confirmed after adjustment for propensity score (P = 0.038). Diabetes diagnosis further refined HCC prediction in patients with compensated advanced chronic liver disease at high baseline risk (P = 0.024). Conclusion: Metabolic comorbidities were associated with advanced liver fibrosis at baseline, whereas statins were protective. In patients with advanced fibrosis, diabetes increased the risk of de novo HCC and of cardiovascular events. Optimization of metabolic comorbidities treatment by a multi-disciplinary management approach may improve cardiovascular and possibly liver-related outcomes., (© 2021 The Authors. Hepatology Communications published by Wiley Periodicals LLC on behalf of American Association for the Study of Liver Diseases.)

Published
2022
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