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6. Real-world virological efficacy and safety of daclatasvir/asunaprevir/beclabuvir in patients with chronic hepatitis C virus genotype 1 infection in Japan

Author

Takaguchi, Koichi, Toyoda, Hidenori, Tsutsui, Akemi, Suzuki, Yoshiyuki, Nakamuta, Makoto, Imamura, Michio, Senoh, Tomonori, Nagano, Takuya, Tada, Toshifumi, Tachi, Yoshihiko, Hiraoka, Atsushi, Michitaka, Kojiro, Shibata, Hiroshi, Joko, Kouji, Okubo, Hironao, Tsuji, Kunihiko, Takaki, Shintaro, Watanabe, Tsunamasa, Ogawa, Chikara, Chayama, Kazuaki, Kumada, Takashi, Kudo, Masatoshi, and Kumada, Hiromitsu

Published
2019
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9. Large Inflammatory Myofibroblastic Tumor of the Esophagus: A Case Report and Literature Review

Author

Yamada, Hyuga, primary, Funasaka, Kohei, additional, Nakagawa, Mitsuru, additional, Hirayama, Yutaka, additional, Horiguchi, Noriyuki, additional, Nagasaka, Mitsuo, additional, Nakagawa, Yoshiyuki, additional, Kuzuya, Teiji, additional, Hashimoto, Senju, additional, Miyahara, Ryoji, additional, Shibata, Tomoyuki, additional, Tachi, Yoshihiko, additional, Tsukamoto, Tetsuya, additional, and Hirooka, Yoshiki, additional

Published
2023
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16. Impact of HBV Infection on Outcomes of Direct-Acting Antiviral Therapy of Chronic Hepatitis C

Author

Hayashi, Kazuhiko, primary, Ishigami, Masatoshi, additional, Ishizu, Yoji, additional, Kuzuya, Teiji, additional, Honda, Takashi, additional, Tachi, Yoshihiko, additional, Ishikawa, Tetsuya, additional, Katano, Yoshiaki, additional, Yoshioka, Kentaro, additional, Toyoda, Hidenori, additional, Kumada, Takashi, additional, Goto, Hidemi, additional, and Hirooka, Yoshiki, additional

Published
2017
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17. Pancreatic Stones

Author

Yamamoto, Satoshi, primary, Inui, Kazuo, additional, Katano, Yoshiaki, additional, Miyoshi, Hironao, additional, Kobayashi, Takashi, additional, Tachi, Yoshihiko, additional, and Torii, Yoshinori, additional

Published
2022
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21. Prevalence of Hepatitis C Virus Genotype 1A in Japan and Correlation of Mutations in the NS5A Region and Single-Nucleotide Polymorphism of Interleukin-28B With the Response to Combination Therapy With Pegylated-Interferon-Alpha 2B and Ribavirin

Author

Hayashi, Kazuhiko, Katano, Yoshiaki, Kuzuya, Teiji, Tachi, Yoshihiko, Honda, Takashi, Ishigami, Masatoshi, Itoh, Akihiro, Hirooka, Yoshiki, Ishikawa, Tetsuya, Nakano, Isao, Urano, Fumihiro, Yoshioka, Kentaro, Toyoda, Hidenori, Kumada, Takashi, and Goto, Hidemi

Published
2012
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23. Marked heterogeneity in the diagnosis of compensated cirrhosis of patients with chronic hepatitis C virus infection in a real‐world setting: A large, multicenter study from Japan

Author

Toyoda, Hidenori, primary, Atsukawa, Masanori, additional, Watanabe, Tsunamasa, additional, Nakamuta, Makoto, additional, Uojima, Haruki, additional, Nozaki, Akito, additional, Takaguchi, Koichi, additional, Fujioka, Shinichi, additional, Iio, Etsuko, additional, Shima, Toshihide, additional, Akahane, Takehiro, additional, Fukunishi, Shinya, additional, Asano, Toru, additional, Michitaka, Kojiro, additional, Tsuji, Kunihiko, additional, Abe, Hiroshi, additional, Mikami, Shigeru, additional, Okubo, Hironao, additional, Okubo, Tomomi, additional, Shimada, Noritomo, additional, Ishikawa, Toru, additional, Moriya, Akio, additional, Tani, Joji, additional, Morishita, Asahiro, additional, Ogawa, Chikara, additional, Tachi, Yoshihiko, additional, Ikeda, Hiroki, additional, Yamashita, Naoki, additional, Yasuda, Satoshi, additional, Chuma, Makoto, additional, Tsutsui, Akemi, additional, Hiraoka, Atsushi, additional, Ikegami, Tadashi, additional, Genda, Takuya, additional, Tsubota, Akihito, additional, Masaki, Tsutomu, additional, Iwakiri, Katsuhiko, additional, Kumada, Takashi, additional, Tanaka, Yasuhito, additional, and Okanoue, Takeshi, additional

Published
2020
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25. Real‐world experience of 12‐week direct‐acting antiviral regimen of glecaprevir and pibrentasvir in patients with chronic hepatitis C virus infection

Author

Toyoda, Hidenori, primary, Atsukawa, Masanori, additional, Watanabe, Tsunamasa, additional, Nakamuta, Makoto, additional, Uojima, Haruki, additional, Nozaki, Akito, additional, Takaguchi, Koichi, additional, Fujioka, Shinichi, additional, Iio, Etsuko, additional, Shima, Toshihide, additional, Akahane, Takehiro, additional, Fukunishi, Shinya, additional, Asano, Toru, additional, Michitaka, Kojiro, additional, Tsuji, Kunihiko, additional, Abe, Hiroshi, additional, Mikami, Shigeru, additional, Okubo, Hironao, additional, Okubo, Tomomi, additional, Shimada, Noritomo, additional, Ishikawa, Toru, additional, Moriya, Akio, additional, Tani, Joji, additional, Morishita, Asahiro, additional, Ogawa, Chikara, additional, Tachi, Yoshihiko, additional, Ikeda, Hiroki, additional, Yamashita, Naoki, additional, Yasuda, Satoshi, additional, Chuma, Makoto, additional, Tsutsui, Akemi, additional, Hiraoka, Atsushi, additional, Ikegami, Tadashi, additional, Genda, Takuya, additional, Tsubota, Akihito, additional, Masaki, Tsutomu, additional, Tanaka, Yasuhito, additional, Iwakiri, Katsuhiko, additional, and Kumada, Takashi, additional

Published
2019
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27. Liver stiffness measurement predicts hepatocellular carcinoma development in patients treated with direct‐acting antivirals

Author

Tachi, Yoshihiko, Hirai, Takanori, Kojima, Yuko, Ishizu, Yoji, Honda, Takashi, Kuzuya, Teiji, Hayashi, Kazuhiko, Ishigami, Masatoshi, and Goto, Hidemi

Subjects
liver stiffness, acoustic radiation force impulse elastography, chronic hepatitis C, Original Article, Original Articles, hepatocellular carcinoma, sustained virological response, digestive system diseases
Abstract

Background and Aim Predictive factors for hepatocarcinogenesis following eradication of hepatitis C virus by direct‐acting antivirals (DAAs) are unknown. The aim of the study was to investigate the relationships between liver stiffness (LS) using acoustic radiation force impulse (ARFI) erastograghy and the development of hepatocellular carcinoma (HCC) in patients who achieved sustained virological response (SVR) treated with DAA. Methods In this prospective study, we enrolled 263 hepatitis C patients with SVR who underwent ARFI before DAA treatment. Thirty patients had previous HCC. Results The median LS value according to ARFI measurements was 1.34 m/s (range: 0.67–4.35). During the follow‐up period (median: 18.1 months), development of HCC occurred in 19 patients (7.2%; HCC occurrence in 7 patients and HCC recurrence in 12 patients). By multivariate Cox regression analysis, HCC history (hazard ratio [HR]: 10.634; 95% confidence interval [CI]: 4.13–27.37; P = 0.001), older age (HR: 4.638; 95% CI: 1.63–13.61; P = 0.004) and higher total bilirubin levels (HR: 4.189; 95% CI: 1.66–10.60; P = 0.002) were independent predictors for the development of HCC, and higher LS value (≥1.73 m/s) at baseline was an independent predictor for HCC occurrence (HR: 8.350; 95% CI: 1.62–43.09; P = 0.011). The cumulative recurrence of HCC was statistically similar according to the degree of LS in patients who were previously treated for HCC. Conclusion The LS value at baseline is useful for predicting HCC occurrence. Thus, even if SVR is achieved, patients with higher LS at baseline must be followed carefully for HCC occurrence.

Published
2017

28. Evaluation of 8‐week glecaprevir/pibrentasvir treatment in direct‐acting antiviral‐naïve noncirrhotic HCV genotype 1 and 2infected patients in a real‐world setting in Japan

Author

Ikeda, Hiroki, primary, Watanabe, Tsunamasa, additional, Atsukawa, Masanori, additional, Toyoda, Hidenori, additional, Takaguchi, Koichi, additional, Nakamuta, Makoto, additional, Matsumoto, Nobuyuki, additional, Okuse, Chiaki, additional, Tada, Toshifumi, additional, Tsutsui, Akemi, additional, Yamashita, Naoki, additional, Kondo, Chisa, additional, Hayama, Korenobu, additional, Kato, Keizo, additional, Itokawa, Norio, additional, Arai, Taeang, additional, Shimada, Noritomo, additional, Asano, Toru, additional, Uojima, Haruki, additional, Ogawa, Chikara, additional, Mikami, Shigeru, additional, Ikegami, Tadashi, additional, Fukunishi, Shinya, additional, Asai, Akira, additional, Iio, Etsuko, additional, Tsubota, Akihito, additional, Hiraoka, Atsushi, additional, Nozaki, Akito, additional, Okubo, Hironao, additional, Tachi, Yoshihiko, additional, Moriya, Akio, additional, Oikawa, Tsunekazu, additional, Matsumoto, Yoshihiro, additional, Tsuruoka, Shuichi, additional, Tani, Joji, additional, Kikuchi, Kan, additional, Iwakiri, Katsuhiko, additional, Tanaka, Yasuhito, additional, and Kumada, Takashi, additional

Published
2019
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29. Trends and Efficacy of Interferon-Free Anti–hepatitis C Virus Therapy in the Region of High Prevalence of Elderly Patients, Cirrhosis, and Hepatocellular Carcinoma: A Real-World, Nationwide, Multicenter Study of 10 688 Patients in Japan

Author

Toyoda, Hidenori, primary, Atsukawa, Masanori, additional, Uojima, Haruki, additional, Nozaki, Akito, additional, Tamai, Hideyuki, additional, Takaguchi, Koichi, additional, Fujioka, Shinichi, additional, Nakamuta, Makoto, additional, Tada, Toshifumi, additional, Yasuda, Satoshi, additional, Chuma, Makoto, additional, Senoh, Tomonori, additional, Tsutsui, Akemi, additional, Yamashita, Naoki, additional, Hiraoka, Atsushi, additional, Michitaka, Kojiro, additional, Shima, Toshihide, additional, Akahane, Takehiro, additional, Itobayashi, Ei, additional, Watanabe, Tsunamasa, additional, Ikeda, Hiroki, additional, Iio, Etsuko, additional, Fukunishi, Shinya, additional, Asano, Toru, additional, Tachi, Yoshihiko, additional, Ikegami, Tadashi, additional, Tsuji, Kunihiko, additional, Abe, Hiroshi, additional, Kato, Keizo, additional, Mikami, Shigeru, additional, Okubo, Hironao, additional, Shimada, Noritomo, additional, Ishikawa, Toru, additional, Matsumoto, Yoshihiro, additional, Itokawa, Norio, additional, Arai, Taeang, additional, Tsubota, Akihito, additional, Iwakiri, Katsuhiko, additional, Tanaka, Yasuhito, additional, and Kumada, Takashi, additional

Published
2019
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30. The efficacy and safety of glecaprevir plus pibrentasvir in 141 patients with severe renal impairment: a prospective, multicenter study

Author

Atsukawa, Masanori, primary, Tsubota, Akihito, additional, Toyoda, Hidenori, additional, Takaguchi, Koichi, additional, Nakamuta, Makoto, additional, Watanabe, Tsunamasa, additional, Michitaka, Kojiro, additional, Ikegami, Tadashi, additional, Nozaki, Akito, additional, Uojima, Haruki, additional, Fukunishi, Shinya, additional, Genda, Takuya, additional, Abe, Hiroshi, additional, Hotta, Naoki, additional, Tsuji, Kunihiko, additional, Ogawa, Chikara, additional, Tachi, Yoshihiko, additional, Shima, Toshihide, additional, Shimada, Noritomo, additional, Kondo, Chisa, additional, Akahane, Takehiro, additional, Aizawa, Yoshio, additional, Tanaka, Yasuhito, additional, Kumada, Takashi, additional, and Iwakiri, Katsuhiko, additional

Published
2019
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34. Comparison of direct sequencing and Invader assay for Y93H mutation and response to interferon-free therapy in hepatitis C virus genotype 1b

Author

Hayashi, Kazuhiko, primary, Ishigami, Masatoshi, additional, Ishizu, Yoji, additional, Kuzuya, Teiji, additional, Honda, Takashi, additional, Kawashima, Hiroki, additional, Ishikawa, Tetsuya, additional, Tachi, Yoshihiko, additional, Hattori, Masashi, additional, Katano, Yoshiaki, additional, Goto, Hidemi, additional, and Hirooka, Yoshiki, additional

Published
2017
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35. Real-World Clinical Application of 12-Week Sofosbuvir/Velpatasvir Treatment for Decompensated Cirrhotic Patients with Genotype 1 and 2: A Prospective, Multicenter Study

Author

Atsukawa, Masanori, Tsubota, Akihito, Kondo, Chisa, Toyoda, Hidenori, Nakamuta, Makoto, Takaguchi, Koichi, Watanabe, Tsunamasa, Hiraoka, Atsushi, Uojima, Haruki, Ishikawa, Toru, Iwasa, Motoh, Tada, Toshifumi, Nozaki, Akito, Chuma, Makoto, Fukunishi, Shinya, Asai, Akira, Asano, Toru, Ogawa, Chikara, Abe, Hiroshi, Hotta, Naoki, Shima, Toshihide, Iio, Etsuko, Mikami, Shigeru, Tachi, Yoshihiko, Fujioka, Shinichi, Okubo, Hironao, Shimada, Noritomo, Tani, Joji, Hidaka, Isao, Moriya, Akio, Tsuji, Kunihiko, Akahane, Takehiro, Yamashita, Naoki, Okubo, Tomomi, Arai, Taeang, Morita, Kiyoshi, Kawata, Kazuhito, Tanaka, Yasuhito, Okanoue, Takeshi, Maeda, Shin, Kumada, Takashi, and Iwakiri, Katsuhiko

Abstract

Introduction: Clinical trials of direct-acting antivirals for patients with decompensated cirrhosis have been conducted, but there is limited information on the medicinal applications in clinical settings. We aimed to evaluate the safety and efficacy of sofosbuvir/velpatasvir for decompensated cirrhotic patients with genotypes 1 and 2 in real-world clinical practice. Methods: A prospective, multicenter study of 12-week sofosbuvir/velpatasvir was conducted for patients with decompensated cirrhosis at 33 institutions. Results: The cohort included 71 patients (52 genotype 1, 19 genotype 2): 7 with Child–Pugh class A, 47 with class B, and 17 with class C (median score 8; range 5–13). The albumin–bilirubin (ALBI) score ranged from -?3.01 to -?0.45 (median -?1.58). Sixty-nine patients (97.2%) completed treatment as scheduled. The overall rate of sustained virologic response at 12 weeks post-treatment (SVR12) was 94.4% (67/71). SVR12 rates in the patients with Child–Pugh classes A, B, and C were 85.7%, 97.9%, and 88.2%, respectively. Among 22 patients with a history of hepatocellular carcinoma treatment, 20 (90.9%) achieved SVR12. The Child–Pugh score and ALBI grade significantly improved after achieving SVR12 (p?=?7.19?×?10-4and 2.42?×?10-4, respectively). Notably, the use of diuretics and branched-chain amino acid preparations significantly reduced after achieving SVR12. Adverse events were observed in 19.7% of the patients, leading to treatment discontinuation in two patients with cholecystitis and esophageal varices rupture, respectively. Conclusion: Twelve weeks of sofosbuvir/velpatasvir in real-world clinical practice yielded high SVR rates and acceptable safety profiles in decompensated cirrhotic patients with genotypes 1 and 2. Achievement of SVR not only restored the liver functional reserve but also reduced or spared the administration of drugs for related complications. Trial Registration: UMIN registration no, 000038587.

Published
2020
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37. Efficacy and tolerability of an IFN-free regimen with DCV/ASV for elderly patients infected with HCV genotype 1B

Author

Toyoda, Hidenori, primary, Kumada, Takashi, additional, Tada, Toshifumi, additional, Shimada, Noritomo, additional, Takaguchi, Koichi, additional, Senoh, Tomonori, additional, Tsuji, Kunihiko, additional, Tachi, Yoshihiko, additional, Hiraoka, Atsushi, additional, Ishikawa, Toru, additional, Shima, Toshihide, additional, and Okanoue, Takeshi, additional

Published
2017
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39. Characteristics and prognosis of hepatocellular carcinoma detected in patients with chronic hepatitis C after the eradication of hepatitis C virus: A multicenter study from Japan

Author

Toyoda, Hidenori, primary, Tada, Toshifumi, additional, Tsuji, Kunihiko, additional, Hiraoka, Atsushi, additional, Tachi, Yoshihiko, additional, Itobayashi, Ei, additional, Takaguchi, Koichi, additional, Senoh, Tomonori, additional, Takizawa, Daichi, additional, Ishikawa, Toru, additional, and Kumada, Takashi, additional

Published
2015
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40. Predictive ability of shear wave elastography for pruritus in chronic hepatitis C patients with sustained virological response.

Author

Yoshihiko Tachi, Takanori Hirai, Yuko Kojima, Yoji Ishizu, Takashi Honda, Teiji Kuzuya, Kazuhiko Hayashi, Masatoshi Ishigami, Hidemi Goto, Yoshiaki Katano, Tachi, Yoshihiko, Hirai, Takanori, Kojima, Yuko, Ishizu, Yoji, Honda, Takashi, Kuzuya, Teiji, Hayashi, Kazuhiko, Ishigami, Masatoshi, Goto, Hidemi, and Katano, Yoshiaki

Published
2018
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41. Validation of Modified ALBI Grade for More Detailed Assessment of Hepatic Function in Hepatocellular Carcinoma Patients: A Multicenter Analysis

Author

Hiraoka, Atsushi, Kumada, Takashi, Tsuji, Kunihiko, Takaguchi, Koichi, Itobayashi, Ei, Kariyama, Kazuya, Ochi, Hironori, Tajiri, Kazuto, Hirooka, Masashi, Shimada, Noritomo, Ishikawa, Toru, Tachi, Yoshihiko, Tada, Toshifumi, Toyoda, Hidenori, Nouso, Kazuhiro, Joko, Kouji, Hiasa, Yoichi, Michitaka, Kojiro, and Kudo, Masatoshi

Abstract

Background/Aim:The frequency of hepatocellular carcinoma (HCC) in patients with good hepatic reserve function has been increasing in Japan along with the progression of antiviral therapies and aging of the society. We evaluated the usefulness of modified albumin-bilirubin (ALBI) grade as a tool for assessment of hepatic reserve function. Materials/Methods:We enrolled 6,649 naïve HCC patients treated from 2000 to 2017 and divided them into training (Ehime Prefecture group: E group, n= 2,357) and validation (validation group: V group, n= 4,292) cohorts. Child-Pugh classification and ALBI and modified ALBI (mALBI) grading were compared using with Japan Integrated Staging (JIS), ALBI-TNM (ALBI-T), and mALBI-T scores, which were calculated based on TNM stage and each assessment tool, retrospectively. Results:In the E group, Akaike’s Information Criterion (AIC) and c-index values for mALBI-T (13,725.2/0.744) were better as compared to those of ALBI-T (13,772.6/0.733) and JIS score (13,874.7/0.720), with similar results observed in the V group (mALBI-T: 27,727.4/0.760; ALBI-T: 27,817.8/0.750; JIS: 27,807.5/0.748). Although there were some significant differences between the groups with regard to clinical background factors (age, etiology, tumor size, tumor number, treatment modalities), for all patients the AIC and c-index values of mALBI-T (45,327.1/0.755) were also better than those of ALBI-T (45,467.7/0.744) and JIS scores (45,555.8/0.739), indicating its superior stratification ability and prognostic predictive value in patients with HCC. Conclusion:The detailed stratification ability of mALBI grade for hepatic reserve function is suitable for the recent trend of HCC patients, while mALBI-T may provide a more accurate predictive value than existing total staging scoring systems.

Published
2019
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45. Characteristics and prognosis of hepatocellular carcinoma detected in patients with chronic hepatitis C after the eradication of hepatitis C virus: A multicenter study from Japan.

Author

Toyoda, Hidenori, Tada, Toshifumi, Tsuji, Kunihiko, Hiraoka, Atsushi, Tachi, Yoshihiko, Itobayashi, Ei, Takaguchi, Koichi, Senoh, Tomonori, Takizawa, Daichi, Ishikawa, Toru, and Kumada, Takashi

Subjects
LIVER cancer, CHRONIC hepatitis C, HEPATITIS C virus, DISEASE relapse, PATIENTS, PROGNOSIS
Abstract

Aim We investigated the characteristics and prognosis of patients with hepatocellular carcinoma (HCC) diagnosed after sustained virological response (SVR) to antiviral therapy for chronic hepatitis C virus (HCV) infection, namely, the eradication of HCV, according to surveillance status after SVR. Methods In this multicenter study, liver function at HCC diagnosis and progression of HCC among patients with HCC diagnosed after SVR were compared. Outcomes were also investigated. Results In patients not under surveillance after SVR, HCC was significantly more advanced at diagnosis, with tumors that were larger in size and of higher stage than in patients who continued under surveillance after SVR. Survival rates were significantly lower in patients not under surveillance ( P < 0.0001). Among patients who were under surveillance, those with a 6-month surveillance interval had larger and higher stage HCC than patients with a 3-month interval. Recurrence rates in patients with a 6-month surveillance interval were significantly higher than in patients with a 3-month surveillance interval ( P = 0.0417). Conclusion Lack of surveillance after SVR was obviously associated with more advanced HCC at detection, resulting in poor prognosis. More importantly, there may be a difference in the severity of HCC at diagnosis and prognosis based on the surveillance interval after SVR. Establishing guidelines how to survey patients with chronic hepatitis C after SVR is necessary. [ABSTRACT FROM AUTHOR]

Published
2016
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48. Liver Fibrosis Indices for Identifying Patients at Low Risk of Developing Hepatocellular Carcinoma after Eradication of HCV

Author

Toyoda, Hidenori, Tada, Toshifumi, Tachi, Yoshihiko, Hirai, Takanori, Yasuda, Satoshi, Honda, Takashi, Hayashi, Kazuhiko, Ishigami, Masatoshi, Goto, Hidemi, and Kumada, Takashi

Abstract

Background Hepatocellular carcinoma (HCC) in patients with chronic hepatitis C can develop after sustained virological response (SVR) to antiviral therapy for HCV, that is, the eradication of HCV, and effective surveillance systems for HCC should be established for this population. We retrospectively evaluated the utility of three laboratory liver fibrosis indices (aspartate aminotransferase-platelet ratio index [APRI], FIB-4 index and Forns index) for identifying patients at low risk of HCC development after SVR, for whom the termination of surveillance for HCC can be considered.Methods APRI, FIB-4 index and Forns index scores were calculated based on laboratory data prior to anti-HCV therapy and at 24 weeks after the end of anti-HCV therapy (SVR24) in 522 patients with SVR who continued surveillance for HCC after SVR. The associations between HCC development and laboratory indices at both points were analysed.Results Twenty-one patients developed HCC after SVR during 2.3–24.4 years follow-up. Whereas HCC developed even in patients with low APRI or FIB-4 index scores, no patients with low Forns index scores developed HCC after SVR. These results were confirmed in a separate cohort of 309 patients who achieved SVR (HCC developed in 17 patients during 1.7–21.6 years follow-up).Conclusions Forns index, especially assessed prior to anti-HCV therapy, was a useful laboratory liver fibrosis index for identifying patients at low likelihood of HCC after SVR. This index may be used as one of indicators to consider the termination of surveillance for HCC after the eradication of HCV.

Published
2017
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49. Large or multiple pseudocysts can impede or complicate the nonsurgical treatment of pancreatolithiasis.

Author

Yamamoto S, Inui K, Katano Y, Miyoshi H, Kobayashi T, and Tachi Y

Abstract

Objectives: We aimed to determine when a coexisting pseudocyst was likely to complicate the nonsurgical treatment of pancreatolithiasis., Methods: We treated 165 patients with pancreatolithiasis nonsurgically between 1992 and 2020, including 21 with pseudocysts. Twelve patients had a single pseudocyst less than 60 mm in diameter. Pseudocysts in the other nine patients had diameters of at least 60 mm or were multiple. The locations of pseudocysts along the length of the pancreas varied from the area with stone involvement to the pancreatic tail. We compared the outcomes in these groups., Results: We found no significant differences in pain relief, stone clearance, stone recurrence, or the likelihood of adverse events between pseudocyst groups or between patients with vs without pseudocysts. However, 4 of 9 patients with large or multiple pseudocysts required transition to surgical treatment (44%) compared with 13 of 144 patients with pancreatolithiasis and no pseudocyst (9.0%) ( P =0.006)., Conclusions: Patients with smaller pseudocysts typically underwent nonsurgical stone clearance successfully with few adverse events, similar to findings in patients with pancreatolithiasis and no pseudocysts. Pancreatolithiasis complicated by large or multiple pseudocysts did not cause more adverse events but was more likely to require transition to surgery compared with pancreatolithiasis without pseudocysts. In patients with large or multiple pseudocysts, early transition to surgery should be considered when nonsurgical treatment is ineffective., Competing Interests: All authors have no conflicts of interest regarding this manuscript.

Published
2023
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50. Time-course changes in liver functional reserve after successful sofosbuvir/velpatasvir treatment in patients with decompensated cirrhosis.

Author

Atsukawa M, Tsubota A, Kondo C, Toyoda H, Nakamuta M, Takaguchi K, Watanabe T, Hiraoka A, Uojima H, Ishikawa T, Iwasa M, Tada T, Nozaki A, Chuma M, Fukunishi S, Asano T, Ogawa C, Abe H, Kato K, Hotta N, Shima T, Matsuura K, Mikami S, Tachi Y, Fujioka S, Okubo H, Shimada N, Tani J, Morishita A, Hidaka I, Moriya A, Tsuji K, Akahane T, Okubo T, Arai T, Kitamura M, Morita K, Kawata K, Tanaka Y, Kumada T, and Iwakiri K

Abstract

Aim: Direct-acting antivirals (DAAs) are currently available even for patients with decompensated cirrhosis. Reportedly, hepatic functional reserve improved in the short term after achievement of sustained virologic response (SVR). We aimed to clarify the outcomes after achievement of SVR in patients with decompensated cirrhosis who were treated by DAAs in real-world clinical practice., Methods: A prospective, multicenter study of 12-week sofosbuvir/velpatasvir was conducted in 86 patients with decompensated cirrhosis, who were evaluated for 48 weeks post-treatment., Results: The cohort included 8 patients with Child-Pugh class A, 56 with B, and 22 with C. The proportion of Child-Pugh class A patients increased from 9.1% at baseline to 44.1% at 48 weeks post-treatment, while that of class B and C patients decreased from 66.2% to 35.1% and from 24.7% to 14.3%, respectively. Among the patients with Child-Pugh class B and C, univariate analysis identified low total bilirubin, Child-Pugh score, Child-Pugh class B, ALBI score, and high serum albumin as factors associated with improvement to Child-Pugh class A. The optimal cut-off value of the factors for predicting improvement to Child-Pugh class A were 1.4 mg/dl for total bilirubin, 2.9 g/dl for serum albumin, 8 points for Child-Pugh score, and -1.88 for ALBI score., Conclusion: Achievement of SVR with sofosbuvir/velpatasvir improved the liver functional reserve at 12 weeks post-treatment and maintained the stable effects until 48 weeks post-treatment in patients with decompensated cirrhosis. Specifically, the patients with less advanced conditions had the likelihood of improving to Child-Pugh class A at 48 weeks post-treatment., (© 2021 Japan Society of Hepatology.)

Published
2022
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