Drug–drug interactions between direct-acting antivirals and co-medications: a territory-wide cohort study

Hui, Vicki Wing‐Ki; Au, Christopher Langjun; Lam, Amy; Yip, Terry Cheuk‐Fung; Tse, Yee‐Kit; Lai, Jimmy Shiu Ming; Chan, Henry Lik‐Yuen; Wong, Vincent Wai‐Sun; Wong, Grace Lai–Hung

doi:10.1007/s12072-022-10402-y

Cited by 9 publications

(6 citation statements)

References 21 publications

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“…There were very few patients taking statins. Drug-drug interactions between DAAs and statins were reported [37], and thus, statin therapy was suspended during DAA therapy. Laboratory parameters were measured by the Institute of Clinical Chemistry and Laboratory Medicine (University Hospital Regensburg).…”

Section: Study Cohortmentioning

confidence: 99%

Sex-specific changes in triglyceride profiles in liver cirrhosis and hepatitis C virus infection

et al. 2022

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Background Hepatitis C virus (HCV) infection is associated with serum lipid abnormalities, which partly normalize following direct-acting antiviral (DAA) therapy. Here, associations of serum triglycerides (TGs) with viral genotype and markers of liver disease severity were evaluated in patients with chronic HCV. Methods The study included the serum of 177 patients with chronic HCV. TGs were quantified by flow injection analysis Fourier transform mass spectrometry. Laboratory values and noninvasive scores for liver fibrosis assessment were determined. The nonparametric Kruskal‒Wallis test, one-way ANOVA, multiple linear regression and Student’s t test were used as appropriate. P values were adjusted for multiple comparisons. Results HCV-infected women had lower serum TGs than men, and thus, a sex-specific analysis was performed. None of the 46 TG species analyzed differed in the serum of female patients with and without liver cirrhosis. In contrast, in the serum of male patients with liver cirrhosis, TGs with 53, 56 and 58 carbon atoms and three to eight double bonds were diminished. These polyunsaturated TGs were also low in males with a high fibrosis-4 score. TGs with 7 or 8 double bonds negatively correlated with the model of end-stage liver disease score in males. In addition, TGs with 49, 51 and 53 carbon atoms were reduced in male patients infected with genotype 3a in comparison to genotype 1a. TGs with 56 carbon atoms were lower in genotype 3a-infected males than in genotype 1b-infected males. TGs did not differ in females by genotype. Genotype 3-related changes disappeared at the end of therapy with DAAs. Overall, the levels of serum TGs did not change during DAA therapy in either sex. Consequently, the serum TGs of males with liver cirrhosis were lower than those of males without cirrhosis at the end of therapy. Such a difference was not apparent in females. Conclusions The decline in TGs observed only in male patients with liver cirrhosis and male patients infected with genotype 3 illustrates sex-specific changes in lipid metabolism in chronic HCV.

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Section: Study Cohortmentioning

confidence: 99%

Sex-specific changes in triglyceride profiles in liver cirrhosis and hepatitis C virus infection

et al. 2022

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“… 11 In another real-world study, patients with potential clinically significant interaction (53.1%) or contraindicated (15.2%) were also often managed by appropriate dose adjustments or temporary withdraw/changing of comedications. 24 Ultimately, an US study on real-world care management of HCV patients treated with SOF/VEL or GLE/PIB reported that pharmacists recommendations concerning DDI were not followed by approximately 40% of the patients. 25 …”

Section: Discussionmentioning

confidence: 99%

Italian Real-World Analysis of the Impact of Polypharmacy and Aging on the Risk of Multiple Drug–Drug Interactions (DDIs) in HCV Patients Treated with Pangenotypic Direct-Acting Antivirals (pDAA)

Fagiuoli

Toniutto

Coppola

et al. 2023

TCRM

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Purpose The study aims at investigating the impact of polymedication and aging in the prevalence of multiple drug-drug interactions (DDIs) on HCV patients treated with sofosbuvir/velpatasvir (SOF/VEL) or glecaprevir/pibrentasvir (GLE/PIB). Patients and Methods This is a retrospective analysis based on administrative data covering around 6.9 million individuals. Patients treated with SOF/VEL or GLE/PIB over November 2017–March 2020 were included. Index date corresponded to SOF/VEL or GLE/PIB first prescription during such period; patients were followed up for treatment duration. Analyses were then focused on patients with ≥2 comedications at risk of multiple DDIs. The severity and the effect of multiple DDI were identified using the Liverpool University tool. Results A total of 2057 patients with SOF/VEL and 2128 with GLE/PIB were selected. Mean age of SOF/VEL patients was 58.5 years, higher than GLE/PIB ones (52.5 years) (p < 0.001), and patients >50 years were more present in SOF/VEL vs GLE/PIB cohorts: 72% vs 58%, (p < 0.001). Most prescribed co-medications were cardiovascular, alimentary and nervous system drugs. Proportion of patients with ≥2 comedications was higher in SOF/VEL compared to GLE/PIB cohort (56.5% vs 32.3%, p < 0.001). Those at high-risk of multiple DDIs accounted for 11.6% (N = 135) of SOF/VEL and 19.6% (N = 135) of GLE/PIB (p < 0.001) patients with ≥2 comedications. Among them, the potential effect of DDI was a decrease of DAA serum levels (11% of SOF/VEL and GLE/PIB patients) and an increased concentration of comedication serum levels (14% of SOF/VEL and 42% of GLE/PIB patients). Conclusion This real-world analysis provided a thorough characterization on the burden of polymedication regimens in HCV patients treated with SOF/VEL or GLE/PIB that expose such patients to an increased risk of DDIs. In our sample population, SOF/VEL regimen was more frequently detected on elderly patients and on those with ≥2 comedications at risk of multi-DDI, ie, among patients characterized by higher rates of comorbidities and polypharmacy.

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“…Drug-drug interactions between a DAA and other concomitant medications (such as PPIs, statins and antipsychotics) remain a concern prior to HCV therapy. 28 Previous studies appeared to suggest that PPI usage can be a modifiable factor determining the success of treatment with SOF + ledipasvir. 29 Our study identified a total of 14.4% of the 194 SOF-treated CHC patients received prescribed concomitant medications during DAA treatment (Table 3).…”

Section: Discussionmentioning

confidence: 99%

“…Drug-drug interactions between a DAA and other concomitant medications (such as PPIs, statins and antipsychotics) remain a concern prior to HCV therapy 28 . Previous studies appeared to suggest that PPI usage can be a modifiable factor determining the success of treatment with SOF + ledipasvir 29 .…”

Section: Discussionmentioning

confidence: 99%

A Ten-Year Retrospective Cohort Study of Real-World Effectiveness of Sofosbuvir-Based Regimens for Hepatitis C in a Single Center in China

Yang,

Xu,

Shen

et al. 2023

Infect Microb Dis

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This study aimed to review the trends of hepatitis C virus (HCV) treatment over the past decade and to analyze the effectiveness of sofosbuvir (SOF)-based direct-acting antiviral regimens in the heterogeneous population of patients with chronic hepatitis C (CHC) in clinical practice. This retrospective cohort study included CHC patients attending the Sir Run Run Shaw Hospital between January 1, 2012 and December 31, 2022. All of the 194 patients treated with SOF-based regimens completed 12 weeks of treatment and were followed up for at least 12 weeks after completion of the therapy. Sustained virologic response (SVR) 12 weeks after the end of treatment was the primary endpoint. A total of 194 patients treated with SOF-based regimens were included, among which 121, 56, 10 and 7 patients received SOF + velpatasvir±ribavirin, SOF + daclatasvir, SOF + ledipasvir or SOF + ribavirin, respectively. With 36.1%, HCV genotype 1 predominated in CHC patients treated with SOF-based regimens, followed by genotype 2a with 17.5% and genotype 3 with 14.9%. Comorbidities among patients included hypertension (4.1%), diabetes (2.1%), depression (1.0%) and neoplastic disease (2.6%). All patients treated with SOF-based regimens achieved SVR. There was no association between SVR and factors such as HCV genotype, sex, age, presence of cirrhosis or previous treatment history. There were no reports of any serious adverse events in the study. This single-center retrospective study represented the latest 10-year treatment trends for HCV in real-world clinical practice and provided useful information on the excellent efficacy of SOF-based direct-acting antiviral regimens for treatment of CHC patients in Eastern China.

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Drug–drug interactions between direct-acting antivirals and co-medications: a territory-wide cohort study

Cited by 9 publications

References 21 publications

Sex-specific changes in triglyceride profiles in liver cirrhosis and hepatitis C virus infection

Sex-specific changes in triglyceride profiles in liver cirrhosis and hepatitis C virus infection

Italian Real-World Analysis of the Impact of Polypharmacy and Aging on the Risk of Multiple Drug–Drug Interactions (DDIs) in HCV Patients Treated with Pangenotypic Direct-Acting Antivirals (pDAA)

A Ten-Year Retrospective Cohort Study of Real-World Effectiveness of Sofosbuvir-Based Regimens for Hepatitis C in a Single Center in China

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