Simeprevir and Sofosbuvir Combination Treatment in a Patient with HCV Cirrhosis and HbS Beta 0-Thalassemia: Efficacy and Safety despite Baseline Hyperbilirubinemia

Papadopoulos, Nikolaos; Deutsch, Melanie; Georgalas, Athanasios; Poulakidas, Helias; Karnesis, Lazaros

doi:10.1155/2016/7635128

Cited by 7 publications

(5 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Moreover, we detected no serious laboratory abnormalities in our patients during treatment. In particular, no case of hyperbilirubinaemia was noticed despite previous reports (Papadopoulos et al, 2016). Iron chelation agents are not included in the usual online tools that most clinicians use to guide their treatment decisions (http://hep-druginterac tions.org/).…”

Section: Discussionmentioning

confidence: 99%

Treatment of chronic hepatitis C with direct‐acting antivirals in patients with β‐thalassaemia major and advanced liver disease

et al. 2017

View full text Add to dashboard Cite

Interferon-based regimens for chronic hepatitis C (CHC) were often deferred in patients with β-thalasaemia major (β-TM) due to poor efficacy and tolerance. Current guidelines recommend direct-acting antivirals (DAAs) for these patients. The aim of this study was to assess the safety and efficacy of DAAs in patients with β-TM and advanced liver disease due to CHC. Patients were recruited from eight liver units in Greece. The stage of liver disease was assessed using transient elastography and/or liver histology. Five regimens were used: sofosbuvir (SOF) + ribavirin (RBV); SOF + simeprevir ± RBV; SOF + daclatasvir ± RBV; ledipasvir/SOF ± RBV and ombitasvir/paritaprevir-ritonavir + dasabuvir ± RBV. Sixty-one patients (median age 43 years) were included. The majority of patients was previously treated for hepatitis C (75%) and had cirrhosis (79%). Viral genotype distribution was: G1a: n = 10 (16%); G1b: n = 22 (36%); G2: n = 2 (3%); G3: n = 14 (23%); G4: n = 13 (22%). The predominant chelation therapy was a combination of deferoxamine and deferiprone (35%). Overall sustained virological response rates were 90%. All treatment regimens were well tolerated and no major adverse events or drug-drug interactions were observed. Approximately half of the patients who received RBV (7/16, 44%) had increased needs for blood transfusion. Treatment of CHC with DAAs in patients with β-TM and advanced liver disease was highly effective and safe.

show abstract

Section: Discussionmentioning

confidence: 99%

Treatment of chronic hepatitis C with direct‐acting antivirals in patients with β‐thalassaemia major and advanced liver disease

et al. 2017

View full text Add to dashboard Cite

show abstract

“…However, patients with haemoglobinopathies and CHC have been excluded from the major clinical trials that led to the approval of DAAs. Indeed, so far, only some case reports have been published showing favourable results after DAAs administration in CHC patients with concurrent haemoglobinopathies 18,19. Hence, at present, no experience is available regarding the safety and efficacy of DAAs in this population which is traditionally considered difficult to treat, because of the coexistence of liver hemochromatosis, the more advanced liver disease and the usual nonresponse or relapse to previous IFN-based therapies.…”

Section: Introductionmentioning

confidence: 99%

Patients With Haemoglobinopathies and Chronic Hepatitis C: A Really Difficult to Treat Population in 2016?

Zachou

Arvaniti²,

Gatselis³

et al. 2016

Mediterr J Hematol Infect Dis

View full text Add to dashboard Cite

Background & objectivesIn the past, patients with haemoglobinopathies were at high risk of acquiring hepatitis C virus (HCV) due to multiple transfusions before HCV screening. In these patients, the coexistence of haemochromatosis and chronic hepatitis C (CHC) often leads to more severe liver disease. We assessed the HCV prevalence, clinical characteristics and outcome in this setting with particular attention to the response to treatment including therapies with the new direct acting antivirals (DAAs).MethodsThe medical records of 81 consecutive patients followed the last 15 years were reviewed retrospectively.Results43/81 (53%) patients were anti-HCV positive including 31/43 (72.1%) with CHC (HCV-RNA positive; age 25±7 years; 45.2% with genotype 1b; 19.4% cirrhotics; baseline ferritin 887 ng/ml; range: 81–10.820). Thirty patients received IFN-based therapy with or without ribavirin with sustained virological response (SVR) in 14/30 (46.7%). Eleven patients (9 non-responders to IFN-based therapies, one in relapse and one naïve) received treatment with DAAs (SVR: 100%). 3/11 patients increased their transfusion needs while 1/11 reported mild arthralgias. No drug-drug interactions between DAAs and chelation agents were observed as attested by the stability of ferritin levels during treatment.ConclusionsMore than 1/3 of patients with haemoglobinopathies suffered from CHC. Response rates to IFN-based treatment seem to be similar to other patients with CHC, while most importantly, treatment with DAAs was excellent and safe even in difficult to treat patients (most null responders with severe fibrosis) suggesting that this group of HCV patients should no longer be regarded as a difficult to treat.

show abstract

“…SIM inhibits hepatic bilirubin transporters (OATP1B1, MRP2), causing hyperbilirubinemia. 10 RBV also could contribute to this effect, causing elevation of unconjugated bilirubin. In our patient, we observed an increase in bilirubin of 3 times.…”

Section: Discussionmentioning

confidence: 99%

Clinical Management of Cirrhotic Patient With HCV Genotype 5 Treated With Simeprevir, Sofosbuvir, and Ribavirin

Morales-Molina¹,

Fernández-Martín²,

Urda-Romacho³

et al. 2016

Ann Pharmacother

View full text Add to dashboard Cite

Letter to the EditorCurrently, hepatitis C infection is present in 180 million people worldwide and is the main cause of end-stage liver disease and an indication for liver transplantation. 1 The different genotypes are independent of the clinical course of chronic hepatitis C but have a great impact on treatment response. New direct-acting antivirals yield a high rate of clinical response and cure. Sofosbuvir (SOF), a NS5B nucleotide inhibitor with pangenotypic activity, presents a high genetic barrier. Simeprevir (SIM), a secondgeneration NS3/A4 protease inhibitor, has activity against genotypes 1, 2, 4, 5, and 6. Also, it shows an interesting characteristic: its resistance-associated variants often disappear gradually once the treatment is stopped. 2 Currently, data on viral response in approved and experimental treatments in HCV genotype 5 (HCV-5) are scarce. Therefore, we propose to describe the first case of healing in a HCV-5 treatment-naïve cirrhotic patient treated with SIM, SOF, and ribavirin (SIM/SOF/RBV)

show abstract

Simeprevir and Sofosbuvir Combination Treatment in a Patient with HCV Cirrhosis and HbS Beta 0-Thalassemia: Efficacy and Safety despite Baseline Hyperbilirubinemia

Cited by 7 publications

References 12 publications

Treatment of chronic hepatitis C with direct‐acting antivirals in patients with β‐thalassaemia major and advanced liver disease

Treatment of chronic hepatitis C with direct‐acting antivirals in patients with β‐thalassaemia major and advanced liver disease

Patients With Haemoglobinopathies and Chronic Hepatitis C: A Really Difficult to Treat Population in 2016?

Clinical Management of Cirrhotic Patient With HCV Genotype 5 Treated With Simeprevir, Sofosbuvir, and Ribavirin

Contact Info

Product

Resources

About