0000000000371479

AUTHOR

Al Zignego

showing 6 related works from this author

Impact of Safety-Related Dose Reductions or Discontinuations on Sustained Virologic Response in HCV-Infected Patients: Results from the GUARD-C Cohor…

2015

Background: Despite the introduction of direct-acting antiviral agents for chronic hepatitis C virus (HCV) infection, peginterferon alfa/ribavirin remains relevant in many resource-constrained settings. The non-randomized GUARD-C cohort investigated baseline predictors of safety-related dose reductions or discontinuations (sr-RD) and their impact on sustained virologic response (SVR) in patients receiving peginterferon alfa/ribavirin in routine practice. Methods: A total of 3181 HCV-mono-infected treatment-naive patients were assigned to 24 or 48 weeks of peginterferon alfa/ribavirin by their physician. Patients were categorized by time-to-first sr-RD (Week 4/12). Detailed analyses of the i…

Genetics and Molecular Biology (all)MaleChronic HepatitisHepacivirusRibavirin/adverse effectsAsthenia/chemically inducedHepacivirusPolyethylene GlycolBiochemistryPolyethylene GlycolsBody Mass IndexChronic Liver Disease0302 clinical medicineNeutropenia/chemically inducedInterferon-alpha/adverse effectsMedicineChroniclcsh:ScienceLiver Diseasesvirus diseasesAntiviral Agents/adverse effectsCohortScience & Technology - Other Topics030211 gastroenterology & hepatologyDrug Therapy CombinationCohort studyHumanmedicine.medical_specialtyAlpha interferonGastroenterology and HepatologyAntiviral AgentsMicrobiologyDose-Response Relationship03 medical and health sciencesPharmacotherapyHepatitis C Chronic/drug therapyDose Prediction MethodsDrug TherapyAnemia/chemically inducedHumansHemoglobinAgedMedicine and health sciencesBiochemistry Genetics and Molecular Biology (all)HepaciviruScience & TechnologyDose-Response Relationship DrugFlaviviruseslcsh:ROrganismsBiology and Life SciencesProteinsmedicine.diseasedigestive system diseaseschemistryAgricultural and Biological Sciences (all)Withholding TreatmentAstheniaImmunologyProportional Hazards Modellcsh:QHuman medicineRNA virusesPhysiologylcsh:MedicinePeginterferon-alfaPolyethylene Glycols/adverse effectsAdult; Aged; Anemia; Antiviral Agents; Asthenia; Cohort Studies; Dose-Response Relationship Drug; Drug Therapy Combination; Female; Hepacivirus; Hepatitis C Chronic; Host-Pathogen Interactions; Humans; Interferon-alpha; Male; Middle Aged; Neutropenia; Outcome Assessment (Health Care); Polyethylene Glycols; Proportional Hazards Models; RNA Viral; Recombinant Proteins; Ribavirin; Withholding Treatment; Agricultural and Biological Sciences (all); Biochemistry Genetics and Molecular Biology (all); Medicine (all)Cohort Studieschemistry.chemical_compoundOutcome Assessment Health CareMedicine and Health Sciences030212 general & internal medicineViralPathology and laboratory medicineMultidisciplinarybiologyHepatitis C virusPharmaceuticsMedicine (all)AnemiaHepatitis CHematologyRecombinant ProteinOutcome Assessment (Health Care)/methodsMiddle AgedMedical microbiologyHepatitis CRecombinant ProteinsHost-Pathogen InteractionMultidisciplinary SciencesPhysiological ParametersResearch DesignCombinationHost-Pathogen InteractionsVirusesRNA ViralFemaleDrugPathogensHost-Pathogen Interactions/drug effectsResearch ArticleAdultNeutropeniaClinical Research DesignResearch and Analysis MethodsOutcome Assessment (Health Care)Internal medicineRibavirinRecombinant Proteins/adverse effectsRNA Viral/bloodAdult; Aged; Anemia; Antiviral Agents; Asthenia; Cohort Studies; Dose-Response Relationship Drug; Drug Therapy Combination; Female; Hepacivirus; Hepatitis C Chronic; Host-Pathogen Interactions; Humans; Interferon-alpha; Male; Middle Aged; Neutropenia; Outcome Assessment (Health Care); Polyethylene Glycols; Proportional Hazards Models; RNA Viral; Recombinant Proteins; Ribavirin; Withholding TreatmentAdult; Aged; Anemia; Antiviral Agents; Asthenia; Cohort Studies; Dose-Response Relationship Drug; Drug Therapy Combination; Female; Hepacivirus; Hepatitis C Chronic; Host-Pathogen Interactions; Humans; Interferon-alpha; Male; Middle Aged; Neutropenia; Outcome Assessment (Health Care); Polyethylene Glycols; Proportional Hazards Models; RNA Viral; Recombinant Proteins; Ribavirin; Withholding Treatment; Medicine (all); Biochemistry Genetics and Molecular Biology (all); Agricultural and Biological Sciences (all)Proportional Hazards ModelsAntiviral Agentbusiness.industryRibavirinBody WeightHepacivirus/drug effectsViral pathogensInterferon-alphaHepatitis C Chronicbiology.organism_classificationHepatitis virusesMicrobial pathogensRNAAdverse EventsCohort StudiebusinessPloS one
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Forecasting Hepatitis C liver disease burden on real-life data. Does the hidden iceberg matter to reach the elimination goals?

2018

Abstract Background & Aims Advances in direct‐acting antiviral treatment of HCV have reinvigorated public health initiatives aimed at identifying affected individuals. We evaluated the possible impact of only diagnosed and linked‐to‐care individuals on overall HCV burden estimates and identified a possible strategy to achieve the WHO targets by 2030. Methods Using a modelling approach grounded in Italian real‐life data of diagnosed and treated patients, different linkage‐to‐care scenarios were built to evaluate potential strategies in achieving the HCV elimination goals. Results Under the 40% linked‐to‐care scenario, viraemic burden would decline (60%); however, eligible patients to treat w…

HCV; WHO; chronic infection; linkage to careLiver Cirrhosismedicine.medical_specialtyCarcinoma HepatocellularSustained Virologic ResponseViral HepatitisSettore MED/12 - GASTROENTEROLOGIAWorld Health OrganizationAntiviral AgentsNO03 medical and health sciencesLiver diseaseWHO0302 clinical medicinePharmacotherapyCost of IllnessCause of DeathHealth caremedicineHumans030212 general & internal medicineViremiachronic infection HCV linkage to care WHODisease EradicationMortalityIntensive care medicineCause of deathlinkage to carechronic infection; HCV; linkage to care; WHODisease EradicationHepatologybusiness.industryPublic healthCarcinomaLiver NeoplasmsHepatocellularHepatitis Cmedicine.diseasechronic infectionHepatitis CMarkov Chainschronic infection; HCV; linkage to care; WHO; Antiviral Agents; Carcinoma Hepatocellular; Cost of Illness; Disease Eradication; Hepatitis C; Humans; Italy; Liver Cirrhosis; Liver Neoplasms; Markov Chains; Mortality; Sustained Virologic Response; Viremia; World Health Organization; Cause of DeathItalychronic infection;HCV;linkage to care;WHOHCVchronic infection; HCV; linkage to care; WHO; Hepatology030211 gastroenterology & hepatologybusinessViral hepatitis
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Modeling cost-effectiveness and health gains of a “universal” versus “prioritized” hepatitis C virus treatment policy in a real-life cohort

2017

We evaluated the cost-effectiveness of two alternative direct-acting antiviral (DAA) treatment policies in a real-life cohort of hepatitis C virus–infected patients: policy 1, “universal,” treat all patients, regardless of fibrosis stage; policy 2, treat only “prioritized” patients, delay treatment of the remaining patients until reaching stage F3. A liver disease progression Markov model, which used a lifetime horizon and health care system perspective, was applied to the PITER cohort (representative of Italian hepatitis C virus–infected patients in care). Specifically, 8,125 patients naive to DAA treatment, without clinical, sociodemographic, or insurance restrictions, were us…

hepatitis C virusPediatricsCost effectivenessViral HepatitisAdult; Aged; Aged 80 and over; Antiviral Agents; Cohort Studies; Cost-Benefit Analysis; Health Policy; Hepatitis C; Humans; Middle Aged; Young Adult; Models Economic; HepatologyCost-Benefit AnalysisDirect-acting antiviralAdult; Aged; Aged 80 and over; Antiviral Agents; Cohort Studies; Cost-Benefit Analysis; Health Policy; Hepatitis C; Humans; Middle Aged; Young Adult; Models EconomicCohort StudiesLiver disease0302 clinical medicineModelsHealth careantiviral therapy80 and overincremental cost-effectiveness ratiohealth care economics and organizationsHCV cost -effectivenessAged 80 and overDirect-acting antiviral hepatocellular carcinoma hepatitis C virus incremental cost-effectiveness ratio interferon quality-adjusted life-years sustained virological response willingness to payCost–benefit analysis030503 health policy & servicesquality-adjusted life-yearsHealth PolicyHepatitis Chepatocellular carcinomainterferonMiddle AgedHepatitis CModels EconomicAdult; Aged; Aged 80 and over; Antiviral Agents; Cohort Studies; Cost-Benefit Analysis; Health Policy; Hepatitis C; Humans; Middle Aged; Young Adult; Models Economic; Hepatology; HCV; antiviral therapy; cost-effectiveness; real-life cohortCohortHCV030211 gastroenterology & hepatologyOriginal Articlesustained virological response0305 other medical scienceCohort studyHumanAdultmedicine.medical_specialtyEconomicAntiviral AgentsNO03 medical and health sciencesYoung Adultreal-life cohortmedicineHumansCost-Benefit Analysicost-effectivenessHealth policyAgedAntiviral AgentHepatologybusiness.industryOriginal Articlesmedicine.diseaseSurgeryCohort Studiebusinesswillingness to pay
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Forecasting liver disease burden

2018

medicine.medical_specialtyLiver diseaseHepatologybusiness.industryGastroenterologymedicineIntensive care medicinemedicine.diseasebusinessDigestive and Liver Disease
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Efficacy and safety of Boceprevir-based therapy in HCVG1 treatment-experienced patients with advanced fibrosis/cirrhosis: Italian NPP survey

2014

S. Bruno1, S. Bollani1, A.L. Zignego2, V. Calvaruso3, C. Magni4, S. Landonio4, M. Rizzetto5, A. Ciancio5, A. Mangia6, V. Piazzolla6, M. Caremani7, S. Piovesan8, L. Cavalletto9, S. Babudieri9, A. Moretti 10, C. Colletta11, M. Massari12, S. Fangazio13, F. Mazzotta14, L. Muratori15, A.E. Colombo16, M. Zuin17, A. Traverso18, T. Santantonio19, F. Farina20, E. Marchionne21, G. Serviddio22, M. Russello23, A. Licata24, A. Craxi3, V. Di Marco3 1 Internal Medicine, AO Fatebenefratelli e Oftalmico, Milano, Italy 2 Internal Medicine, Universita di Firenze, Italy 3 Gastroenterology, Universita di Palermo, Italy 4 Infectiuos Diseases, Ospedale Sacco, Milano, Italy 5 Gastroenterology, Universita di Torino…

medicine.medical_specialtyHepatologybusiness.industryInfectious disease (medical specialty)Family medicineGastroenterologymedicinebusinessTreatment experiencedAdvanced fibrosisDigestive and Liver Disease
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Effectiveness and safety of glecaprevir/pibrentasvir in chronic hepatitis C patients: Results of the Italian cohort of a post-marketing observational…

2021

Abstract Background and Aims The MARS post-marketing, observational study evaluates glecaprevir/pibrentasvir in a large population of Italian patients who are infected with HCV. Patients and Methods Achievement of SVR12 was the primary endpoint in the overall population and by subpopulations of interest (treatment-naive and treatment-experienced patients, subjects infected with different HCV genotype/sub-genotype, cirrhotic and non-cirrhotic patients, patients with different severity of fibrosis, patients with an APRI score ≥1, subjects with comorbidities, HIV-coinfected patients, elderly patients and people who use drugs). Safety and quality of life (assessed by SF-36 and Work Productivity…

MaleAdultmedicine.medical_specialtyPyrrolidinesQuinoxalineSustained Virologic ResponseSettore MED/12 - GASTROENTEROLOGIAPopulationAntiviral AgentselderlyBenzimidazoleGLE/PIBQuinoxalinesInternal medicineDrug CombinationClinical endpointmedicineProduct Surveillance PostmarketingHumansProspective StudieseducationAdverse effectAgedAntiviral AgentSulfonamideseducation.field_of_studyHepatologybusiness.industrySettore MED/09 - MEDICINA INTERNAGastroenterologyPWUDGlecaprevirMiddle Agedelderly; GLE/PIB; HCV; PWUDHepatitis C ChronicPibrentasvirDiscontinuationDrug CombinationsGLE/PIB; HCV; PWUD; elderlyItalyCohortHCVQuality of LifeBenzimidazolesFemaleObservational studybusiness
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