Abstract

BACKGROUND: Sofosbuvir use in patients with decompensated cirrhosis may be associated with reduced liver transplant waitlist mortality and reduced need for transplant.METHODS: Data from the Scientific Registry of Transplant Recipients were linked with a national database of pharmacy claims. All adult patients on the liver transplant waiting list on January 1, 2014, or added to the list during 2014, with hepatitis C virus as reason for listing were identified (total n = 2009). A subgroup of 1093 unique patients had consistent pharmacy claim capture and observations. We compared patients who were and were not treated with all sofosbuvir-based regimens.RESULTS: During the study period, 154 patients received sofosbuvir-based regimens. These patients had lower model for end-stage liver disease scores and significantly longer waiting times. We found a trend toward significance for more sofosbuvir-treated than untreated patients being removed from the waiting list due to improved condition (4.54% vs. 3.19%, P = 0.03). In a propensity-score-adjusted analysis, sofosbuvir-treated patients were less likely to undergo transplant (HR 0.57; 95% CI 0.37-0.89; P = 0.01).CONCLUSION: During the study period reflecting early sofosbuvir use, few liver transplant candidates received sofosbuvir. Use was associated with lower incidence of transplant and a trend toward more waitlist removals due to improved condition. This article is protected by copyright. All rights reserved.

View details for DOI 10.1002/phar.2237

View details for PubMedID 30779203