{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T23:11:22Z","timestamp":1779923482447,"version":"3.53.1"},"reference-count":35,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2019,5,15]],"date-time":"2019-05-15T00:00:00Z","timestamp":1557878400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Liver International"],"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background&amp;Aims<\/jats:title><jats:p>Since the introduction of direct\u2010acting antivirals (DAAs) several\u00a0studies have reported high efficacy and safety\u00a0in Hepatitis C infected patients, even in those earlier considered difficult\u2010to\u2010treat. We aimed to assess the efficacy and safety of DAA therapy in elderly patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The PubMed MEDLINE, Embase and Cochrane databases were searched through July 2018. Two independent researchers extracted data and assessed the quality and risk of bias. Risk ratios (RRs) were pooled using random effects models. The primary outcome was efficacy of DAA therapy assessed by the RR for non\u2010sustained virologic response (SVR) among patients aged &lt;65 vs \u226565\u00a0years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, we identified 63 studies including 34 082 patients treated with different DAAs. Risk for non\u2010SVR was comparable in patients &lt;65 and \u226565\u00a0years of age (RR 1.00, 95% CI 0.86\u20101.15; <jats:italic>P<\/jats:italic>\u00a0=\u00a00.979) and even lower in a subgroup analysis of cirrhotic patients \u226565\u00a0years of age (RR 0.59, 95% CI 0.35\u20100.99, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.044). Risk for non\u2010SVR was similar between age groups in all other subgroup analyses. Elderly patients had a significantly increased risk of adverse events (AEs) (RR 1.30, 95% CI 1.11\u20101.52, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.001), but not for serious adverse events (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.43) or treatment discontinuation (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.15). Risk for anaemia if treated with additional ribavirin was 2.84 (95% CI 1.73\u20104.66, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) in elderly patients compared to patients &lt;65\u00a0years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our results show that DAAs are highly effective and safe in elderly patients. Ribavirin should be avoided in the elderly as more AEs and particularly anaemia is observed. Further cost\u2010effectiveness analyses are needed to evaluate the socio\u2010economic benefit of treating elderly people without advanced liver disease.<\/jats:p><\/jats:sec>","DOI":"10.1111\/liv.14126","type":"journal-article","created":{"date-parts":[[2019,4,29]],"date-time":"2019-04-29T11:48:10Z","timestamp":1556538490000},"page":"1652-1660","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Efficacy and safety of direct\u2010acting antivirals for hepatitis C in the elderly: A systematic review and meta\u2010analysis"],"prefix":"10.1111","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8475-8369","authenticated-orcid":false,"given":"Marcus M.","family":"M\u00fccke","sequence":"first","affiliation":[{"name":"Department of Internal Medicine 1 University Hospital Frankfurt Frankfurt am Main 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