Acute pancreatitis associated with boceprevir: a case report

Abstract

Approximately 170 million people are infected with hepatitis C, and the sustained virological response rate to treatment with pegylated interferon and ribavirin is 30-50%. In an attempt to improve the chances of cure, boceprevir is being added to therapy, but it is associated with an increased incidence of adverse events. We herein report a case of acute pancreatitis developed during treatment with pegylated interferon, ribavirin and boceprevir. Boceprevir was the most likely cause of drug-associated pancreatitis after the most common causes were ruled out, since this adverse event had not occurred when the patient had previously been exposed to pegylated interferon and ribavirin and there was no recurrence of the episode of pancreatitis when these two drugs were reintroduced. Acute pancreatitis is a rare adverse event associated with boceprevir therapy, but a potentially fatal event. Sequential determination of pancreatic enzymes should be considered during hepatitis C treatment with boceprevir.

Randomised clinical trial: alisporivir combined with peginterferon and ribavirin in treatment‐naïve patients with chronic HCV genotype 1 infection (ESSENTIAL II)

“…This analysis also found use of interferon to be associated with a higher prevalence of acute pancreatitis in patients with HCV infection (2.7%). Pancreatitis has also been observed in patients receiving telaprevir and boceprevir in combination with PR, and as an adverse event during treatment with sofosbuvir and ribavirin . In the telaprevir core clinical trial programme, pancreatitis was reported in 7/2669 (0.3%) patients treated with telaprevir in combination with PR; however, there were no cases of pancreatitis in the 764 patients treated with PR alone .…”

Drug-Induced Acute Pancreatitis in Adults: Focus on Antimicrobial and Antiviral Drugs, a Narrative Review

“…According to individual case reports, other drugs with a less obvious association with AP are atazanavir, darunavir, and boceprevir [20,120]. The first two were not included in the Wolfe and Simons-Linares classification, but pancreatitis is listed in the product information as a risk factor and/or adverse drug reaction (ADR) [10].…”

Updates in drug-induced acute pancreatitis

“…Recently, the high safety profiles associating DAAs had denied any linkage with DIP occurrence. However, boceprevir and telaprevir were mentioned in such a fatal condition in two separate reports [37,38]. Conversely, later generations of DAAs had been mentioned to cause DIP only in cases with ribavirin including regimens.…”