Comorbidities, Comedication and Potential Drug to Drug Interactions in Chronic Hepatitis C Patients: Implications for Adequate HCV Treatment Selection

Sicras, Antoni; Ferrer, Vicenç Falcó; Navarro, Ricardo Scarparo; Sáez-Zafra, Marc

doi:10.1016/s0168-8278(16)01456-2

Cited by 6 publications

(6 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Moreover, in real life, patients often bear co-morbidities and receive multiple medications leading to potential drug-to-drug interactions, making current HCV treatment more challenging than expected. SOF/VEL regimen was shown associated with no or limited interactions with other co-medications taken for co-morbidities [9].…”

Section: Introductionmentioning

confidence: 99%

SVR12 rates higher than 99% after sofosbuvir/velpatasvir combination in HCV infected patients with F0-F1 fibrosis stage: A real world experience

et al. 2019

View full text Add to dashboard Cite

Background and objectives The pangenotypic single tablet regimen of NS5B inhibitor sofobuvir (SOF) and NS5A inhibitor velpatasvir (VEL) is advised for 12 weeks in HCV-infected patients including those with compensated cirrhosis. Addition of ribavirin (RBV) may be considered in genotype 3 (GT3) with compensated and is recommended in decompensated cirrhosis. Real-life results with SOF/VEL are limited. To evaluate efficacy and safety in a large real-world-cohort including patients with different GTs and various fibrosis stages. Design In total, 1429 patients were treated with SOF/VEL 400/100 mg for 12 weeks in the Puglia registry between June 2017 and May 2018. 1319 (92.3%) reached week 12 post-treatment (SVR12) at the moment. Only 41 received RBV. Diagnosis of cirrhosis was based on transient elastography and/or APRI or FIB-4 scores. Sensitivity analysis in the population including all patients except non virological failure was conducted. Primary efficacy endpoint was the percentage of patients with SVR12. Results Patients’ mean age was 63.8 years, 42.3% had GT1. The majority were naïve and 735 (55.5%) F0/F2. Of the remaining 587, 282 had cirrhosis. SVR12 was 98.5%, 98.0% in GT1, 99.4% in GT2, 97.1% in GT3, 100% in GT4. Overall, SVR12 by sensitivity analysis was 99.4%; 99.7% among F0-F1. Among 218 PWID, SVR12 was 94.5%. Discontinuation rates were 3.7% among PWID and 0.7% among non-PWID (p = 0.004). Conclusions SOF/VEL treatment of chronic HCV infection reaches very high cure rates in a variety of patients; including those with F0/F1 and PWID.

show abstract

Section: Introductionmentioning

confidence: 99%

SVR12 rates higher than 99% after sofosbuvir/velpatasvir combination in HCV infected patients with F0-F1 fibrosis stage: A real world experience

et al. 2019

View full text Add to dashboard Cite

show abstract

“…First, our study investigated potential DDIs between DAAs and concomitant medications, rather than actual DDIs in clinical practice. However, other DDI studies adopted a similar methodology and investigated potential DDIs between DAAs and other medications rather than actual DDIs . In clinical practice, actual DDIs could be reduced with a thorough medication review, but it requires time and effort from physicians and pharmacists .…”

Section: Discussionmentioning

confidence: 99%

“…Given the large number of potential concomitant medications and limited pharmacokinetic data, DDIs have become a challenge in the era of DAAs, particularly for patients with multiple comorbidities who use a number of concomitant medications . Several studies in the USA, Spain, Germany, France, Japan and Taiwan have examined potential DDIs in HCV‐infected patients receiving DAAs in clinical practice . The US and German studies showed that patients with cirrhosis received a higher number of concomitant medications compared with patients with no cirrhosis, and a higher number of concomitant medications was also associated with higher rates of potential DDIs .…”

Section: Introductionmentioning

confidence: 99%

“…16 Several studies in the USA, Spain, Germany, France, Japan and Taiwan have examined potential DDIs in HCV-infected patients receiving DAAs in clinical practice. [17][18][19][20][21][22][23][24][25] The US and German studies showed that patients with cirrhosis received a higher number of concomitant medications compared with patients with no cirrhosis, and a higher number of concomitant medications was also associated with higher rates of potential DDIs. 17,20 In Japan, 39% of patients with chronic HCV infection were taking at least one medication contraindicated to DAA regimens, and the percentage increased from 21% in patients aged 18-34 years to 44% in patients aged 65-74 years.…”

Section: Introductionmentioning

confidence: 99%

“…However, other DDI studies adopted a similar methodology and investigated potential DDIs between DAAs and other medications rather than actual DDIs. 18,19,22 In clinical practice, actual DDIs could be reduced with a thorough medication review, but it requires time and effort from physicians and pharmacists. 17 Second, as active ingredients were counted instead of each drug, DDIs may be over-counted since some active ingredients are always taken together as a combined therapy (eg, amlodipine and valsartan combined as a fixed-dose combination for the treatment of hypertension).…”

mentioning

confidence: 99%

See 2 more Smart Citations

Comorbidities, concomitant medications and potential drug‐drug interactions with interferon‐free direct‐acting antiviral agents in hepatitis C patients in Taiwan

Liu¹,

Yu²,

Peng³

et al. 2018

Aliment Pharmacol Ther

View full text Add to dashboard Cite

Summary Background While direct‐acting antivirals have been approved for treating hepatitis C, the guidelines highlight the importance of considering potential drug‐drug interactions between DAAs and concomitant medications. Aim To assess comorbidity prevalence, concomitant medication use and potential drug‐drug interactions between DAAs and concomitant medications for hepatitis C patients in Taiwan. Methods This cross‐sectional study enrolled 822 patients from May to August 2016 in Taiwan. Patient demographics, comorbidities and concomitant medications were evaluated by physician surveys. Results A total of 709 (86.3%) patients had ≥1 comorbidity; the most prevalent comorbidity categories were diseases of the digestive system (40.1%), circulatory system (38.7%) and endocrine/nutritional/metabolic diseases (35.2%). Elderly patients had more comorbidities. A total of 622 (75.7%) patients received ≥1 concomitant medication; the average number of concomitant medications was 3.2. The most common concomitant medication classes were cardiovascular (34.4%), gastrointestinal (25.7%) and central nervous system drugs (22.7%). Among patients without cirrhosis or with compensated cirrhosis, contraindications were most prevalent with paritaprevir/ritonavir/ombitasvir plus dasabuvir, daclatasvir/asunaprevir and glecaprevir/pibrentasvir (13.3%, 6.0% and 5.4% respectively), and least prevalent with sofosbuvir, sofosbuvir/daclatasvir, sofosbuvir/ledipasvir and sofosbuvir/velpatasvir (0.8%, 1.3%, 1.4% and 2.1% respectively). Sofosbuvir‐based regimens had no contraindications in patients with decompensated cirrhosis. Conclusion Our population represented an elderly demographic, with a high prevalence of comorbidities and widespread use of concomitant medications. The potential drug‐drug interactions between these concomitant medications and DAA regimens differed, with the fewest potential interactions with sofosbuvir‐based regimens.

show abstract

Pharmacist-led pre-treatment assessment, management and outcomes in a Hepatitis C treatment patient cohort

et al. 2019

View full text Add to dashboard Cite

Comorbidities, Comedication and Potential Drug to Drug Interactions in Chronic Hepatitis C Patients: Implications for Adequate HCV Treatment Selection

Cited by 6 publications

References 0 publications

SVR12 rates higher than 99% after sofosbuvir/velpatasvir combination in HCV infected patients with F0-F1 fibrosis stage: A real world experience

SVR12 rates higher than 99% after sofosbuvir/velpatasvir combination in HCV infected patients with F0-F1 fibrosis stage: A real world experience

Comorbidities, concomitant medications and potential drug‐drug interactions with interferon‐free direct‐acting antiviral agents in hepatitis C patients in Taiwan

Pharmacist-led pre-treatment assessment, management and outcomes in a Hepatitis C treatment patient cohort

Contact Info

Product

Resources

About