Risk factors for severe anaemia during telaprevir‐based triple therapy: is acquired renal dysfunction the missing link?

Pariente, Alexandre; Remy, André‐Jean; Lesgourgues, Bruno; Hagège, Hervé

doi:10.1111/liv.12510

Cited by 4 publications

(4 citation statements)

References 3 publications

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“…Of note, degree of fibrosis did not significantly impact eGFR decline. Interestingly, patients with grade 2 anaemia or more during treatment had a significant lower eGFR at D0 but did not experience a lower eGFR nadir in contrast to previous results .…”

Section: Discussioncontrasting

confidence: 96%

eGFR decrease during antiviral C therapy with first generation protease inhibitors: a clinical significance?

Loustaud‐Ratti

Rousseau

Carrier

et al. 2014

Liver International

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The eGFR significantly varied in telaprevir group only. Our model showed that eGFR nadir mainly depended on initial eGFR. As telaprevir has been shown to inhibit mostly the drug transporter OCT2 which interacts with creatinine transport, the early decrease of eGFR observed could be a benign phenomenon. However, as unpredictable true renal toxicity may occur during therapy, we recommend a thorough follow-up of eGFR.

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Section: Discussioncontrasting

confidence: 96%

eGFR decrease during antiviral C therapy with first generation protease inhibitors: a clinical significance?

Loustaud‐Ratti

Rousseau

Carrier

et al. 2014

Liver International

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“…Recent reports suggest that acquired renal dysfunction is crucial for an increase in RBV blood levels and anemia, supporting our assumption. 16,17 In our cohort, RBV was administered at a moderate but stable dose from baseline and was adapted in only one case because of renal insufficiency but not because of the Hb level. A decrease in the Hb level was supported with EPO or blood transfusions when necessary, thereby efficiently stabilizing the patients' condition without reducing therapeutic efficacy.…”

Section: Discussionmentioning

confidence: 99%

Daily Low-dose Tacrolimus Is a Safe and Effective Immunosuppressive Regimen During Telaprevir-based Triple Therapy for Hepatitis C Virus Recurrence After Liver Transplant

et al. 2015

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“…Although renal dysfunction has not been listed as a safety concern in multiple previous clinical trials of TVR and serious renal adverse events have not been noted, TVR-induced renal dysfunction has been previously reported (18)(19)(20)(21)(22)(23). Renal dysfunction is now recognized as a critical complication of TVR-based triple therapy (18)(19)(20)(21)(22)(23). Higher incidences of serious impairment of eGFR (<60 ml/min) were previously observed in patients receiving TVR or boceprevir with peg-IFN and RBV (6.6 and 4.7%, respectively) when compared with those receiving dual therapy with peg-IFN and RBV only (0.9%) (19).…”

Section: Discussionmentioning

confidence: 99%

Analysis of renal function during telaprevir-based triple therapy for chronic hepatitis C

Kohjima

Kurokawa

Enjoji

et al. 2016

Experimental and Therapeutic Medicine

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Telaprevir (TVR) is used for the treatment of chronic hepatitis C in a combination therapy with pegylated-interferon and ribavirin. Although renal dysfunction is one of the critical adverse outcomes of this treatment, little is known regarding the mechanism of its onset. The present study assessed the association of renal function with TVR dose and viral response. Hematological, biochemical, urinary and virological parameters of renal function were examined during the TVR-based triple therapy of patients infected with hepatitis C virus (HCV) genotype 1b. Serum creatinine levels were increased and the estimated glomerular filtration rate (eGFR) was decreased in every patient during TVR administration, but these values recovered to normal levels following cessation of TVR. Fractional excretion of sodium was <1% at days 3 and 7, appearing similar regardless of baseline renal function. Urinary β-microglobulin levels were elevated and were significantly higher in patients with renal dysfunction, as compared with those not exhibiting renal dysfunction (P<0.05). The reduction in renal function was milder in patients treated with a reduced TVR dose, and these patients had a significantly lower risk of developing renal dysfunction (P<0.05). Using a multivariate analysis, TVR dose and eGFR at the initiation of treatment were identified as significant contributory factors in the development of renal dysfunction. Reduction in TVR dose did not lead to a significant increase in the viral kinetics of HCV or detrimental effects on the sustained viral response (SVR) rate. It is hypothesized that renal dysfunction during TVR treatment is caused by damage of the renal tubule, in addition to pre-renal dysfunction, and that reduction in TVR dose reduces the rate of renal dysfunction without causing a significant decrease in the SVR rate.

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Risk factors for severe anaemia during telaprevir‐based triple therapy: is acquired renal dysfunction the missing link?

Cited by 4 publications

References 3 publications

eGFR decrease during antiviral C therapy with first generation protease inhibitors: a clinical significance?

eGFR decrease during antiviral C therapy with first generation protease inhibitors: a clinical significance?

Daily Low-dose Tacrolimus Is a Safe and Effective Immunosuppressive Regimen During Telaprevir-based Triple Therapy for Hepatitis C Virus Recurrence After Liver Transplant

Analysis of renal function during telaprevir-based triple therapy for chronic hepatitis C

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