Su1421 Impact of Proton Pump Inhibitors on Achieving SVR from 8 Week Course of Ledipasvir/Sofosbuvir

Marshall, Vanessa; Hirsch, Amy; Rife, Kelsey; Silveira, Marina Nogueira; Compan, Anita; Moreland, A.; Falck‐Ytter, Yngve

doi:10.1016/s0016-5085(16)33698-8

Cited by 2 publications

(4 citation statements)

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“… 11 Therefore, nine cohort studies with 32,684 participants met the eligibility criteria. 8 , 10 – 17 The literature retrieval, review, and selection process are shown in Fig. 1 .…”

Section: Resultsmentioning

confidence: 99%

“…Seven of nine studies in this meta-analysis reported the interaction of PPIs and the LDV/SOF regimen. 8 , 10 – 14 , 17 Only one study by Terrault et al 11 showed a significantly decreased achievement of SVR among PPI users daily. Tapper et al 10 showed that twice daily PPI use was associated with lower odds ratio for SVR but not daily PPI use.…”

Section: Discussionmentioning

confidence: 99%

“…All DAA therapy can interact with PPIs, which affect gastric pH and can affect DAA bioavailability, thereby leading to sub-therapeutic levels of antiviral drugs and possibly to failure to achieve SVR. 8 – 11 In fact, recent epidemiologic studies have reported the possible association between HCV-infected patients with DAA therapy concomitant use PPIs and lower odds of achieving SVR compared to non-PPI users. 8 , 10 – 17 However, the results are still inconsistent.…”

Section: Introductionmentioning

confidence: 99%

“… 8 – 11 In fact, recent epidemiologic studies have reported the possible association between HCV-infected patients with DAA therapy concomitant use PPIs and lower odds of achieving SVR compared to non-PPI users. 8 , 10 – 17 However, the results are still inconsistent. Thus, this systematic review and meta-analysis was conducted to summarize all available evidence with the aim of better characterizing this relationship.…”

Section: Introductionmentioning

confidence: 99%

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Efficacy and Safety of Direct-acting Antivirals in Hepatitis C Virus-infected Patients Taking Proton Pump Inhibitors

Wijarnpreecha

Chesdachai

Jaruvongvanich

et al. 2017

Journal of Clinical and Translational Hepatology

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Background and Aims: Direct-acting antiviral (DAA) therapy is the cornerstone of the treatment of chronic hepatitis C virus (HCV) infection. Eradication of HCV, predicted by the attainment of a sustained virologic response (SVR) 12 weeks following DAA therapy, is the goal of this treatment. Interestingly, recent studies have reported the possible association between HCV-infected patients with DAA therapy concomitant use of proton pump inhibitors (PPIs) and lower odds of achieving SVR. This meta-analysis was conducted to summarize all available data and to estimate this potential association.Methods: Comprehensive literature review was conducted by first searching the Medline and Embase databases through March 2017 to identify all studies that investigated the safety and efficacy of DAAs in patients with HCV infection taking PPIs versus those without PPIs. Adjusted point estimates from each study were combined by the generic inverse variance method of DerSimonian and Laird.Results: Nine cohort studies with 32,684 participants met the eligibility criteria and were included in the meta-analysis. The use of PPIs concomitant with DAAs among HCV-infected patients was associated with lower odds of achieving SVR compared with non-PPI users (pooled odds ratio (OR): 0.74, 95% confidence interval (CI): 0.63–0.88, I2 = 24%). Subgroup analysis addressed the association between PPIs use and SVR12 demonstrated the association of PPI users showing lower odds of achieving SVR12 compared with those with no use of PPIs (pooled OR: 0.68, 95% CI: 0.51–0.9, I2 = 33%).Conclusions: This study demonstrated a significantly increased risk of failure to achieve SVR in HCV-infected patients taking DAA with PPIs compared to non-PPI users. Providers should consider whether PPI therapy is indicated for patients and withdraw of PPI therapy in the absence of indications, especially while on DAA therapy.

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“… 11 Therefore, nine cohort studies with 32,684 participants met the eligibility criteria. 8 , 10 – 17 The literature retrieval, review, and selection process are shown in Fig. 1 .…”

Section: Resultsmentioning

confidence: 99%