R Kraus – Advisory Committees or Review Panels: Merck/MSD, Roche

R. Kraus – Advisory Committees or Review Panels: Merck/MSD, Roche, Gilead, BMS, Janssen, ABBVIE; Consulting: Merck/MSD, Roche; Speaking and Teaching: Merck/MSD, Gilead, BMS, Janssen, ABBVIE Bernd Weber – Advisory Committees or Review Panels: Molteni Farmaceutici, Bristol Myers Squibb, AbbVie; Speaking and Teaching: Roche Pharma AG, Janssen Cilag, Reckitt Benckiser, Sandoz, Lundbeck Pharma, Sanofi-Aventis, MSD, Gilead Sciences Uwe Naumann – Speaking and Teaching: MSD, Roche, BMS, Abbott, VIIV, Jans-sen, Boehringer Ingelheim, Gilead Dagmar Hartmann – Employment: MSD Germany Bernd Dreher – Employment: MSD Manfred Bilzer – Consulting: MSD Germany The following people have nothing to disclose: Hanns

F. Loehr, Hermann Stef-fens, Christine John, Peter R. Geyer, Thomas mTOR inhibitor Witthoeft, Andreas Herrmann, Selinexor price Mark Hoesl, Elmar Zehnter Background and Aims: New therapies for hepatitis C virus (HCV) were well-tolerated in registration trials, but results in practice can differ. We aimed to characterize patients experiencing hepatic decompensation and severe adverse events (SAE) in a real-world setting and to identify potential risk factors. Methods: HCV infected patients on combination regimens that included sofosbuvir (SOF) and/or simeprevir (SIM) were analyzed using a Case-Control design. The Cases (n=9) experienced at least

one of the following: hepatic decompensation, indicated by new or increased jaundice, ascites, encephalop-athy, or sepsis, or another SAE. Three Controls were selected for each Case based on treatment regimen and duration. Eight Cases and all 27 Controls were from our Institutional cohort of 230 patients receiving contemporaneous treatment for HCV. Data were collected on demographics, medical history, stage of liver disease, laboratory values, description of the decompensation/SAE. The two groups were compared using matched conditional exact analysis. The incidence of decompensation/SAE

was calculated for the 8 Cases from our cohort. Results: All Cases (n=9) and Controls (n=27) medchemexpress were above the age of 45 yr. Of the 36 patients, 16 (45%) were on SOF/ribavirin (RBV), 12 (33%) were on SIM/SOF, 4 were on SIM/SOF/RBV, and 4 were on SOF/RBV/Peg-IFN; 26 (72%) had genotype 1 HCV. Five Cases had jaundice, 3 had sepsis (bacteremia, SBP, urosepsis), 3 had ascites, 2 had encephalop-athy, and 1 had deep venous thrombosis. These events were first noted at a median time on treatment of 5 wk (range 2-12) and led to treatment discontinuation in 4, hospitalization in 3, and death in 1. Baseline variables associated with increased risk of decompensation/SAE were higher total bilirubin [odds ratio (OR) = 7.83 mg/dL; 95% CI 1.64-125.54], higher INR (OR = 3.12 /0.1U; 95% CI 1.09 – 98.44), lower albumin (OR=0.18 g/dL; 95% CI 0.02-0.76), and lower creatinine (OR=0.48 per 0.1 mg/dL; 95% CI 0.19 – 0.92). The incidence of decompensation/SAE was 8/223 (3.5%).

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