0000000001269672

AUTHOR

Manuela Merli

0000-0003-3173-9767

showing 6 related works from this author

Safety and efficacy of ombitasvir/paritaprevir/ritonavir/dasabuvir plus ribavirin in patients over 65 years with HCV genotype 1 cirrhosis

2018

Purpose: To analyse safety and efficacy of treatment based on ombitasvir/paritaprevir/ritonavir/dasabuvir plus ribavirin in the sub-group of GT1 patients older than 65 years. Methods: We collected data extracted from the ABACUS compassionate-use nationwide Italian programme, in patients with cirrhosis due to hepatitis C virus (HCV) Genotype-1 (GT1) or 4 and at high risk of decompensation. GT1-HCV-infected patients received once-daily ombitasvir/paritaprevir, with the pharmacokinetic enhancer ritonavir (25/150/100 mg) and twice-daily dasabuvir (250 mg) plus Ribavirin (RBV) (OBV/PTV/r + DSV + RBV) for 12 (GT1b) or 24 (GT1a) weeks. Endpoints were to evaluate safety and efficacy, the latter def…

CyclopropanesLiver CirrhosisMaleCirrhosis;Dasabuvir;Elderly;Ombitasvir;ParitaprevirCirrhosis; Dasabuvir; Elderly; Ombitasvir; Paritaprevir; Aged; Aged; 80 and over; Anilides; Antiviral Agents; Biomarkers; Carbamates; Female; Hepacivirus; Hepatitis C; Chronic; Humans; Liver Cirrhosis; Macrocyclic Compounds; Male; Ribavirin; Ritonavir; Sulfonamides; Treatment Outcome; Uracil; Drug Therapy; Combination; GenotypeParitaprevirCirrhosis Dasabuvir Elderly Ombitasvir Paritaprevir Microbiology (medical) Infectious DiseasesCirrhosis; Dasabuvir; Elderly; Ombitasvir; Paritaprevir; Aged; Aged 80 and over; Anilides; Antiviral Agents; Biomarkers; Carbamates; Female; Hepacivirus; Hepatitis C Chronic; Humans; Liver Cirrhosis; Macrocyclic Compounds; Male; Ribavirin; Ritonavir; Sulfonamides; Treatment Outcome; Uracil; Drug Therapy Combination; Genotype; Microbiology (medical); Infectious DiseasesHepacivirusGastroenterologychemistry.chemical_compound0302 clinical medicineElderly2-Naphthylamine80 and overMedicineAnilides030212 general & internal medicineChronicAged 80 and overSulfonamidesDasabuvirValineGeneral MedicineHepatitis CHepatitis CTreatment OutcomeInfectious DiseasesCirrhosisCombination030211 gastroenterology & hepatologyDrug Therapy CombinationFemaleDasabuvirMacrocyclic CompoundCirrhosis; Dasabuvir; Elderly; Ombitasvir; Paritaprevir; Microbiology (medical); Infectious Diseasesmedicine.drugHumanMicrobiology (medical)medicine.medical_specialtyMacrocyclic CompoundsProlineGenotypeLactams MacrocyclicSettore MED/12 - GASTROENTEROLOGIALiver CirrhosiSulfonamideAntiviral Agents03 medical and health sciencesDrug TherapyInternal medicineRibavirinHumansDecompensationUracilAgedHepatitisAntiviral AgentCirrhosiHepaciviruRitonavirbusiness.industryRibavirinSettore MED/09 - MEDICINA INTERNAAnilideBiomarkerHepatitis C Chronicmedicine.diseaseCirrhosis; Dasabuvir; Elderly; Ombitasvir; Paritaprevir; Aged; Aged 80 and over; Anilides; Antiviral Agents; Biomarkers; Carbamates; Female; Hepacivirus; Hepatitis C Chronic; Humans; Liver Cirrhosis; Macrocyclic Compounds; Male; Ribavirin; Ritonavir; Sulfonamides; Treatment Outcome; Uracil; Drug Therapy Combination; GenotypeOmbitasvirOmbitasvirchemistryParitaprevirCarbamateRitonavirCarbamatesbusinessBiomarkers
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Liver transplantation for severe alcoholic hepatitis: A multicenter Italian study

2022

There is increasing evidence that early liver transplantation (eLT), performed within standardized protocols can improve survival in severe alcoholic hepatitis (sAH). The aim of the study was to assess outcomes after eLT for sAH in four Italian LT centers and to compare them with non-responders to medical therapy excluded from eLT. Patients admitted for sAH (2013–2019), according to NIAAA criteria, were included. Patients not responding to medical therapy were placed on the waiting list for eLT after a strict selection. Histological features of explanted livers were evaluated. Posttransplant survival and alcohol relapse were evaluated. Ninety-three patients with severe AH were evaluated (65…

Maleclinical decision-makingTransplantationWaiting Listsalcoholism and substance abuseHepatitis AlcoholicPatient SelectionalllocationSettore MED/09 - MEDICINA INTERNAalcoholism and substance abuse; clinical decision-making; clinical research/practice; liver transplantation/hepatologyalcoholic hepatitiMiddle Agedclinical research/practiceLiver TransplantationRecurrenceMED/18 - CHIRURGIA GENERALEHumansImmunology and AllergyFemaleethicPharmacology (medical)Liver transplantliver transplantation/hepatologyAmerican Journal of Transplantation
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On-treatment serum albumin level can guide long-term treatment in patients with cirrhosis and uncomplicated ascites

2021

Background & Aims: The ANSWER study reported that long-term albumin administration in patients with cirrhosis and uncomplicated ascites improves survival. During treatment, serum albumin increased within a month and remained stable thereafter. In this post hoc analysis, we aimed to determine whether on-treatment serum albumin levels could guide therapy. Methods: Logistic regression was used to assess the association between baseline serum albumin and mortality, as well as to determine on-treatment factors associated with mortality and to predict the achievement of a given on-treatment serum albumin level. Survival was assessed by Kaplan-Meier estimates and second-order polynomial regres…

Male0301 basic medicineCirrhosisascites; complications; liver cirrhosis; serum albumin; survivalSerum albuminSurvival.Logistic regressionGastroenterologyBiomarkers PharmacologicalAscites; Cirrhosis; Complications; Serum albumin; Survivalascites0302 clinical medicineAscitesMedicinebiologyMiddle AgedIntention to Treat AnalysisTreatment OutcomeCirrhosisAsciteFemale030211 gastroenterology & hepatologyDrug Monitoringmedicine.symptommedicine.medical_specialtycomplicationsSettore MED/12 - GASTROENTEROLOGIAliver cirrhosisSerum albuminSerum Albumin Humansurvival03 medical and health sciencesSerum albumin levelPredictive Value of TestsInternal medicinePost-hoc analysisHumansIn patientBiological ProductsCirrhosiHepatologybusiness.industryAlbuminmedicine.diseaseLong-Term CareSurvival Analysis030104 developmental biologybiology.proteinbusinessComplication
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Long-term albumin administration in decompensated cirrhosis (ANSWER): an open-label randomised trial

2018

Background Evidence is scarce on the efficacy of long-term human albumin (HA) administration in patients with decompensated cirrhosis. The human Albumin for the treatmeNt of aScites in patients With hEpatic ciRrhosis (ANSWER) study was designed to clarify this issue. Methods We did an investigator-initiated multicentre randomised, parallel, open-label, pragmatic trial in 33 academic and non-academic Italian hospitals. We randomly assigned patients with cirrhosis and uncomplicated ascites who were treated with anti-aldosteronic drugs (≥200 mg/day) and furosemide (≥25 mg/day) to receive either standard medical treatment (SMT) or SMT plus HA (40 g twice weekly for 2 weeks, and then 40 g weekly…

Liver CirrhosisMaleTime FactorsCirrhosisKaplan-Meier Estimatelaw.inventionascites0302 clinical medicineHepatorenal syndromeRandomized controlled trialFurosemidelawAscitesClinical endpointParacentesisDiureticsalbumin decompensated cirrhosiMineralocorticoid Receptor AntagonistsSettore MED/12 - GastroenterologiaMedicine (all)Hazard ratioGeneral MedicineMiddle AgedSurvival RateCirrhosis030220 oncology & carcinogenesisDrug Therapy CombinationFemale030211 gastroenterology & hepatologyQuality-Adjusted Life Yearsmedicine.symptomHyponatremiamedicine.medical_specialty03 medical and health sciencesAlbuminsInternal medicinemedicineHumansSurvival ratealbuminAgedbusiness.industrycirrhosis; albumin; ascitesmedicine.diseaseClinical trialalbumin cirrhosis ascites liver decompensationQuality of LifeHyperkalemiabusinessEsophagus Varices Portal Hypertension Varicosis
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Multiclass HCV resistance to direct-acting antiviral failure in real-life patients advocates for tailored second-line therapies

2017

Background & Aims: Despite the excellent efficacy of direct-acting antivirals (DAA) reported in clinical trials, virological failures can occur, often associated with the development of resistance-associated substitutions (RASs). This study aimed to characterize the presence of clinically relevant RASs to all classes in real-life DAA failures. Methods: Of the 200 virological failures that were analyzed in 197 DAA-treated patients, 89 with pegylated-interferon+ribavirin (PegIFN+RBV) and 111 without (HCV-1a/1b/1g/2/3/4=58/83/1/6/24/25; 56.8% treatment experienced; 65.5% cirrhotic) were observed. Sanger sequencing of NS3/NS5A/NS5B was performed by home-made protocols, at failure (N= 200) and w…

Male0301 basic medicinehepatitis C virusSustained Virologic ResponseSofosbuvirHepacivirusDrug ResistanceHepacivirusresistance-associated substitutionsViral Nonstructural ProteinsVARIANTSNS5Amedicine.disease_causeGastroenterologychemistry.chemical_compound0302 clinical medicineRecurrenceINFECTIONantiviral therapyMedicinehepatitis C viruViralTreatment FailureChronicantiviral therapy; direct-acting antivirals; hepatitis C virus; resistance test; resistance-associated substitutions; hepatologybiologyGENOTYPE 1virus diseasesMiddle Agedantiviral therapy; direct-acting antivirals; hepatitis C virus; resistance test; resistance-associated substitutionsSettore MED/07 - Microbiologia e Microbiologia ClinicaHepatitis CItalyCombinationInterferonDrug Therapy CombinationFemale030211 gastroenterology & hepatologyAuthor Keywords:antiviral therapyRIBAVIRINSequence AnalysisHumanmedicine.drugmedicine.medical_specialtyDaclatasvirGenotypeHepatitis C virusAntiviral AgentsLONG-TERM PERSISTENCEDACLATASVIR03 medical and health sciencesDrug Therapyantiviral therapy; direct-acting antivirals; hepatitis C virus; resistance test; resistance-associated substitutions; Aged; Antiviral Agents; Drug Resistance Viral; Drug Therapy Combination; Female; Genotype; Hepacivirus; Hepatitis C Chronic; Humans; Interferons; Italy; Male; Middle Aged; Mutation; Recurrence; Ribavirin; Sequence Analysis DNA; Sofosbuvir; Sustained Virologic Response; Treatment Failure; Viral Nonstructural Proteins; HepatologyTREATMENT-NAIVEInternal medicineDrug Resistance ViralRibavirinHumansNS5Aresistance testdirect-acting antiviralsAgedAntiviral Agentresistance-associated substitutiondirect-acting antiviralHepaciviruHepatologyresistance test KeyWords Plus:HEPATITIS-C VIRUSbusiness.industryRibavirinViral Nonstructural ProteinSequence Analysis DNADNAHepatitis C ChronicHepatologybiology.organism_classificationClinical trial030104 developmental biologySOFOSBUVIRchemistrySequence AnalysihepatologyMutationImmunologyInterferonsSofosbuvirbusiness
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Ombitasvir, paritaprevir, and ritonavir, with or without dasabuvir, plus ribavirin for patients with hepatitis C virus genotype 1 or 4 infection with…

2017

Summary Background We ran a compassionate use nationwide programme (ABACUS) to provide access to ombitasvir, paritaprevir, and ritonavir, with dasabuvir, plus ribavirin for hepatitis C virus (HCV) genotype 1 infection and ombitasvir, paritaprevir, and ritonavir, plus ribavirin for HCV genotype 4 infection in patients with cirrhosis at high risk of decompensation while approval of these regimens was pending in Italy. Methods In this prospective observational study, we collected data from a compassionate use nationwide programme from March 17, 2014, to May 28, 2015. Patients with HCV genotype 1 infection and cirrhosis at high risk of decompensation were given coformulated ombitasvir (25 mg), …

CyclopropanesCompassionate Use TrialsLiver CirrhosisMalechemistry.chemical_compound0302 clinical medicine2-NaphthylamineHCV direct-acting antiviral mixed cryoglobulinemia RBVAnilides030212 general & internal medicineLongitudinal StudiesProspective StudiesChronicAdult; Aged; Anilides; Antiviral Agents; Carbamates; Compassionate Use Trials; Drug Therapy Combination; Female; Genotype; Hepatitis C Chronic; Humans; Liver Cirrhosis; Longitudinal Studies; Macrocyclic Compounds; Male; Middle Aged; Prospective Studies; Ribavirin; Ritonavir; Sulfonamides; Treatment Outcome; UracilSettore MED/12 - GastroenterologiaSulfonamidesDasabuvirHCV DAAGastroenterologyvirus diseasesValineMiddle AgedSettore MED/07 - Microbiologia e Microbiologia ClinicaHepatitis CTreatment OutcomeGastroenterology; HepatologyCombinationDrug Therapy Combination030211 gastroenterology & hepatologyFemalemedicine.drugAdultmedicine.medical_specialtyMacrocyclic CompoundsProlineGenotypeLactams MacrocyclicAdult; Aged; Anilides; Antiviral Agents; Carbamates; Compassionate Use Trials; Drug Therapy Combination; Female; Genotype; Hepatitis C Chronic; Humans; Liver Cirrhosis; Longitudinal Studies; Macrocyclic Compounds; Male; Middle Aged; Prospective Studies; Ribavirin; Ritonavir; Sulfonamides; Treatment Outcome; Uracil; Hepatology; GastroenterologyHepatitis C virus genotype 1 Hepatitis C virus genotype 4 decompensated liver cirrhosis antiviral therapy dasabuvir ombitasvir paritaprevirHepatology; GastroenterologyAntiviral Agents03 medical and health sciencesDrug TherapyInternal medicineRibavirinmedicineHumansDecompensationAdverse effectUracilAgedRitonavirHepatologybusiness.industryRibavirinHepatitis C ChronicVirologyOmbitasvirClinical trialchemistryParitaprevirRitonavirCarbamatesbusiness
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