eISSN: 2449-8238
ISSN: 2392-1099
Clinical and Experimental Hepatology
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SCImago Journal & Country Rank
3/2019
vol. 5
 
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abstract:
Original paper

Effect of comedication on ombitasvir/paritaprevir/ritonavir ± dasabuvir ± ribavirin therapy in chronic hepatitis C – a real-world study

Krzysztof Adam Simon
1, 2
,
Robert Flisiak
3
,
Tadeusz Wojciech Łapiński
3
,
Ewa Janczewska
4
,
Marta Wawrzynowicz-Syczewska
5
,
Jerzy Jaroszewicz
3
,
Dorota Zarębska-Michaluk
6
,
Khalil Nazzal
7
,
Beata Bolewska
8
,
Jolanta Białkowska
9
,
Hanna Berak
10
,
Katarzyna Fleischer-Stępniewska
11
,
Krzysztof Tomasiewicz
12
,
Kornelia Karwowska
13
,
Karolina Anna Rostkowska
1, 2
,
Anna Piekarska
14
,
Olga Tronina
15
,
Grzegorz Madej
1, 16
,
Aleksander Garlicki
17
,
Mariusz Łucejko
3
,
Arkadiusz Pisula
4
,
Ewa Karpińska
5
,
Wiesław Kryczka
6
,
Alicja Wiercińska-Drapało
7
,
Iwona Mozer-Lisewska
8
,
Maciej Stanisław Jabłkowski
9
,
Andrzej Horban
10, 18
,
Brygida Knysz
11
,
Magdalena Tudrujek
12
,
Waldemar Halota
13

1.
Provincial Specialist Hospital. J. Gromkowskiego, Wroclaw, Poland
2.
Department of Infectious Diseases and Hepatology, Wroclaw Medical University, Poland
3.
Department of Infectious Diseases and Hepatology, Medical University of Bialystok, Poland
4.
Hepatology Outpatient Clinic, ID Clinic, Myslowice, Poland
5.
Department of Infectious Diseases, Hepatology and Liver Transplantation, Pomeranian Medical University, Szczecin, Poland
6.
Department of Infectious Diseases, Voivodeship Hospital and Jan Kochanowski University, Kielce, Poland
7.
Department of Tropical and Infectious Disease and Hepatology, Medical University of Warsaw, Poland
8.
Department of Infectious Diseases, Poznan University of Medical Sciences, Poland
9.
Department of Infectious and Liver Diseases, Medical University of Lodz, Poland
10.
Daily Unit, Hospital of Infectious Diseases in Warsaw, Poland
11.
Department of Infectious Diseases, Liver Diseases and Immune Deficiencies, Wroclaw Medical University, Poland
12.
Department of Infectious Diseases and Hepatology, Medical University of Lublin, Poland
13.
Department of Infectious Diseases and Hepatology, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland
14.
Department of Infectious Diseases and Hepatology, Medical University of Lodz, Poland
15.
Department of Transplantation Medicine, Nephrology and Internal Medicine, Medical University of Warsaw, Poland
16.
2nd Department of Infectious Diseases, Voivodeship Specialist Hospital, Wroclaw, Poland
17.
Department of Infectious and Tropical Diseases, Jagiellonian University Medical College, Krakow, Poland
18.
Department of Adult’s Infectious Diseases, Medical University of Warsaw, Poland
Clin Exp HEPATOL 2019; 5, 3: 215–223
Online publish date: 2019/09/05
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Aim of the study
This multicentre study aimed to examine the actual risk for drug-drug interactions in a cohort of Polish patients, and their impact on antiviral therapy.

Material and methods
Concomitant medications were analyzed in hepatitis C virus (HCV)-infected patients treated with still valuable therapy with OBV/PTV/r ± DSV ± RBV. An established online tool (http://www.hep-druginteractions.org/) was used to assess potential drug interactions. To assess the impact of comedications on virologic outcomes, HCV RNA levels were measured at given time points during and after the treatment. The results were compared between subgroups depending on the number of drugs used.

Results
Among the 209 patients included in this multicentre study, concomitant medications were taken by 140 (67.0%) patients. Modification of treatment due to expected interactions was required in 33 (15.8%) patients, of whom nine (4.3%) had at least one comedication replaced or discontinued. Sustained virologic response rates ranged from 95.1% to 100.0%, and were lowest in patients taking one to five comedications who were null-responders to pegylated interferon or cirrhotic.

Conclusions
Although most HCV-infected patients received concomitant medications, only some required treatment modification. OBV/PTV/r ± DSV ± RBV was effective in all subgroups, irrespective of the number of comedications taken. Multimorbidity and polypharmacy in patients with chronic hepatitis C should not discourage the decision to initiate antiviral therapy, although caution should be exercised for potential drug-drug interactions.

keywords:

HCV infection, direct-acting antivirals, drug-drug interactions

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