26 research outputs found

    Copper-Catalyzed Activation of α‑Amino Peroxy and Hydroxy Intermediates to Iminium Ion Precursor: An Access to C4-Substituted 3,4-Dihydroquinazolines via Oxidative Cross Coupling Strategy

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    A simple and straightforward approach to access C4-substituted-3,4-dihydroquinazolines has been achieved, where copper-catalyzed activation of α-amino peroxide and hydroxide intermediates to iminium ion precursors has been realized as an important step. Reactions of these intermediates with alkynes, indoles, pyrrole, and silylenol ether afforded the structurally diverse C4-substituted-3,4-dihydroquinazoline derivatives in good yields

    Enrollment and patient disposition.

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    <p><sup>a</sup>Other reasons (more than one reason may apply to a given patient): no final confirmation from the investigator (n = 56); contraindications to therapy (n = 15); HCV RNA-negative at screening/baseline (n = 12); end-stage renal disease (n = 7); major organ transplantation (n = 2); not treated with peginterferon alfa (n = 1) or ribavirin (n = 2); acute hepatitis C (n = 1); co-infection with HIV (n = 115); co-infection with HBV (n = 74); treatment with regimen other than peginterferon alfa-2a/ribavirin or peginterferon alfa-2b/ribavirin (n = 14); treatment-naive and intended treatment duration of 72 weeks (n = 6).</p

    Scoring system used to identify patients in subgroup 2<sup>a</sup> with a high or low probability of achieving SVR24.

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    <p>Scoring system used to identify patients in subgroup 2<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0151703#t001fn001" target="_blank"><sup>a</sup></a> with a high or low probability of achieving SVR24.</p

    Cox proportional hazards analysis for time to first safety-related dose reductions or discontinuations in patients treated for 24 or 48 weeks with peginterferon alfa-2a or alfa-2b and ribavirin.

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    <p>(A) All treatment-naive patients (G1–6) assigned to 24 or 48 weeks of treatment with peginterferon alfa-2a or alfa-2b/RBV (N = 3181); (B) Subgroup 2: treatment-naive Caucasian, G1 noncirrhotic patients assigned to 48 weeks of treatment with peginterferon alfa-2a/RBV (n = 951).</p

    A comprehensive assessment of patient reported symptom burden, medical comorbidities, and functional well being in patients initiating direct acting antiviral therapy for chronic hepatitis C: Results from a large US multi-center observational study

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    <div><p>Background</p><p>Symptom burden, medical comorbidities, and functional well-being of patients with chronic hepatitis C virus (HCV) initiating direct acting antiviral (DAA) therapy in real-world clinical settings are not known. We characterized these patient-reported outcomes (PROs) among HCV-infected patients and explored associations with sociodemographic, liver disease, and psychiatric/substance abuse variables.</p><p>Methods and findings</p><p>PROP UP is a large US multicenter observational study that enrolled 1,600 patients with chronic HCV in 2016–2017. Data collected prior to initiating DAA therapy assessed the following PROs: number of medical comorbidities; neuropsychiatric, somatic, gastrointestinal symptoms (PROMIS surveys); overall symptom burden (Memorial Symptom Assessment Scale); and functional well-being (HCV-PRO). Candidate predictors included liver disease markers and patient-reported sociodemographic, psychiatric, and alcohol/drug use features. Predictive models were explored using a random selection of 700 participants; models were then validated with data from the remaining 900 participants. The cohort was 55% male, 39% non-white, 48% had cirrhosis (12% with advanced cirrhosis); 52% were disabled or unemployed; 63% were on public health insurance or uninsured; and over 40% had markers of psychiatric illness. The median number of medical comorbidities was 4 (range: 0–15), with sleep disorders, chronic pain, diabetes, joint pain and muscle aches being present in 20–50%. Fatigue, sleep disturbance, pain and neuropsychiatric symptoms were present in over 60% and gastrointestinal symptoms in 40–50%. In multivariable validation models, the strongest and most frequent predictors of worse PROs were disability, unemployment, and use of psychiatric medications, while liver markers generally were not.</p><p>Conclusions</p><p>This large multi-center cohort study provides a comprehensive and contemporary assessment of the symptom burden and comorbid medical conditions in patients with HCV treated in real world settings. Pain, fatigue, and sleep disturbance were common and often severe. Sociodemographic and psychiatric markers were the most robust predictors of PROs. Future research that includes a rapidly changing population of HCV-infected individuals needs to evaluate how DAA therapy affects PROs and elucidate which symptoms resolve with viral eradication.</p><p>Trial registration</p><p>(Clinicaltrial.gov: <a href="https://clinicaltrials.gov/ct2/show/NCT02601820" target="_blank">NCT02601820</a>).</p></div