Elevated serum uric acid level was a notable adverse event during combination therapy with sofosbuvir and ribavirin

Sato, Ken; Naganuma, Atsushi; Nagashima, Tamon; Hoshino, Takashi; Uehara, Daisuke; Arai, Yousuke; Horiuchi, Katsuhiko; Yuasa, K; Takayama, Hisashi; Arai, Hajime; Hatanaka, Takeshi; Ohyama, Tatsuya; Tahara, Hiroki; Sohara, Naondo; Kobayashi, Takeshi; Horiguchi, Norio; Yamazaki, Yuichi; Kakizaki, Satoru; Kusano, Motoyasu; Yamada, Masanobu; Murase, Takayo; Nakamura, Takashi

doi:10.1111/hepr.12971

Cited by 10 publications

(10 citation statements)

References 13 publications

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“…hyperuricemia, and fatigue, as well as genotoxicity and teratogenicity in younger patients. [30][31][32] Apart from a better safety profile, LDV/SOF, as an RBV-free regimen, has been associated with a better health-related quality of life (HRQOL) in chronic HCV patients both during and after treatment, compared with RBV-containing regimens. An analysis of 494 genotype 1 and genotype 2 HCV patients in Japan treated with LDV/SOF±RBV and SOF+RBV with similar HRQOL scores at baseline found that more AEs were experienced during treatment by those who received RBV-containing regimens compared to those who received RBV-free regimens (46% vs. 22%).…”

Section: Discussionmentioning

confidence: 99%

Twelve weeks of ledipasvir/sofosbuvir all‐oral regimen for patients with chronic hepatitis C genotype 2 infection: Integrated analysis of three clinical trials

Asahina

Liu

Gane

et al. 2020

Hepatology Research

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The combination of ledipasvir and sofosbuvir (LDV/SOF) has been approved for the treatment of various hepatitis C virus (HCV) genotypes across many countries. This article presents an integrated analysis of three prospective phase II/III trials in the Asia Pacific region to evaluate the efficacy and safety of 12 weeks of LDV/SOF in HCV genotype 2 patients without cirrhosis or with compensated cirrhosis. Methods: A total of 200 patients were included in the integrated analysis. The primary end point was the rate of sustained virologic response for 12 weeks after the end of therapy (SVR12), analyzed by fibrosis stage, treatment history, HCV genotype subtype, and presence of baseline resistance associated substitutions (RAS). Safety was evaluated by adverse events and laboratory abnormalities.

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Section: Discussionmentioning

confidence: 99%

Twelve weeks of ledipasvir/sofosbuvir all‐oral regimen for patients with chronic hepatitis C genotype 2 infection: Integrated analysis of three clinical trials

Asahina

Liu

Gane

et al. 2020

Hepatology Research

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“…An animal study demonstrated that SUA levels may decrease after DAA treatment . Nevertheless, it has been suggested that SUA levels may increase via the performance of human studies . It should be noted that the sample sizes in the previous studies were small.…”

Section: Discussionmentioning

confidence: 94%

“…For example, the elevated SUA levels during ribavirin use may be misinterpreted, due to the hemolysis of red blood cells . Sofosbuvir has been proposed to affect the levels of xanthine oxidoreductase, which may cause the elevation of SUA levels . In the current study, the post‐treatment SUA levels were measured 3 months after the end of treatment, at which time the potential drug interferences may have been washed out.…”

Section: Discussionmentioning

confidence: 95%

“…29 Nevertheless, it has been suggested that SUA levels may increase via the performance of human studies. 30,31 It should be noted that the sample sizes in the previous studies were small. Importantly, drugs that may alter SUA levels were not excluded from previous work as they were in this study.…”

Section: Discussionmentioning

confidence: 97%

“…30,32 Sofosbuvir has been proposed to affect the levels of xanthine oxidoreductase, which may cause the elevation of SUA levels. 31 In the current study, the post-treatment SUA levels were measured 3 months after the end of treatment, at which time the potential drug interferences may have been washed out. As a result, we observed that the SUA decrements were consistent among the patients with or without sofosbuvir use, and patients with ribavirin use continued to demonstrate decreased SUA levels.…”

Section: Discussionmentioning

confidence: 99%

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Improvement of hyperuricemia in chronic hepatitis C patients receiving directly acting antiviral agents

Jang

Huang

Yeh

et al. 2019

J of Gastro and Hepatol

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Background and Aim Hepatitis C virus eradication via the use of antivirals ameliorates metabolic profiles. The changes in serum uric acid (SUA) levels in chronic hepatitis C patients who receive antivirals are not well understood. We aimed to address this issue by comparing the SUA changes before and after the achievement of a sustained virological response (which is defined as hepatitis C virus RNA seronegativity at 12 weeks after the end of treatment). Methods Two hundred and thirteen sustained virological response patients who were treated by directly acting antivirals were consecutively enrolled. Pretreatment and post‐treatment SUA levels were compared. Hyperuricemia was defined as a uric acid level > 7.0 mg/dL in men and > 6.0 mg/dL in women. Results The SUA levels significantly decreased after treatment, as compared to the pretreatment levels (5.6 ± 1.5 vs 6.0 ± 1.7 mg/dL, respectively; P < 0.001). The proportion of hyperuricemia incidences significantly decreased after treatment (25.8% vs 35.7%, respectively; P = 0.001). The improvement was only observed in patients with a fibrosis‐4 index (FIB‐4) < 6.5 (25.7% vs 37.1%, P = 0.001) but not in those patients with a FIB‐4 ≧ 6.5 (26.3% vs 28.9%, P = 1.00). A multivariate analysis revealed that the factor that was associated with significantly decreased SUA levels was FIB‐4 < 6.5 (odds ratio [OR]/95% confidence interval [CI]: 3.22/1.04–9.95, P = 0.04) and estimated glomerular filtration rate < 60 mL/min/1.73 m2 (OR/CI: 4.34/1.94–9.73, P < 0.001). There existed a trend of a higher proportion of patients with significant SUA improvement along with the decrement of FIB‐4 (29.7%, 25%, and 10.5% in patients with FIB‐4 < 3.25, 3.25–6.5, and > 6.5, respectively; trend P = 0.03). Conclusions SUA levels were significantly decreased in chronic hepatitis C patients after viral eradication. The improvement was particularly enhanced in patients with mild liver disease.

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Uric acid en route to gout

Zhang

2023

Advances in Clinical Chemistry

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Elevated serum uric acid level was a notable adverse event during combination therapy with sofosbuvir and ribavirin

Cited by 10 publications

References 13 publications

Twelve weeks of ledipasvir/sofosbuvir all‐oral regimen for patients with chronic hepatitis C genotype 2 infection: Integrated analysis of three clinical trials

Twelve weeks of ledipasvir/sofosbuvir all‐oral regimen for patients with chronic hepatitis C genotype 2 infection: Integrated analysis of three clinical trials

Improvement of hyperuricemia in chronic hepatitis C patients receiving directly acting antiviral agents

Uric acid en route to gout

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