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3/2019
vol. 5
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
,
Tadeusz Wojciech Łapiński
3
,
Marta Wawrzynowicz-Syczewska
5
,
Dorota Zarębska-Michaluk
6
,
Katarzyna Fleischer-Stępniewska
11
,
Krzysztof Tomasiewicz
12
,
Karolina Anna Rostkowska
1, 2
,
Alicja Wiercińska-Drapało
7
,
Maciej Stanisław Jabłkowski
9
,
- Provincial Specialist Hospital. J. Gromkowskiego, Wroclaw, Poland
- Department of Infectious Diseases and Hepatology, Wroclaw Medical University, Poland
- Department of Infectious Diseases and Hepatology, Medical University of Bialystok, Poland
- Hepatology Outpatient Clinic, ID Clinic, Myslowice, Poland
- Department of Infectious Diseases, Hepatology and Liver Transplantation, Pomeranian Medical University, Szczecin, Poland
- Department of Infectious Diseases, Voivodeship Hospital and Jan Kochanowski University, Kielce, Poland
- Department of Tropical and Infectious Disease and Hepatology, Medical University of Warsaw, Poland
- Department of Infectious Diseases, Poznan University of Medical Sciences, Poland
- Department of Infectious and Liver Diseases, Medical University of Lodz, Poland
- Daily Unit, Hospital of Infectious Diseases in Warsaw, Poland
- Department of Infectious Diseases, Liver Diseases and Immune Deficiencies, Wroclaw Medical University, Poland
- Department of Infectious Diseases and Hepatology, Medical University of Lublin, Poland
- Department of Infectious Diseases and Hepatology, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland
- Department of Infectious Diseases and Hepatology, Medical University of Lodz, Poland
- Department of Transplantation Medicine, Nephrology and Internal Medicine, Medical University of Warsaw, Poland
- 2nd Department of Infectious Diseases, Voivodeship Specialist Hospital, Wroclaw, Poland
- Department of Infectious and Tropical Diseases, Jagiellonian University Medical College, Krakow, Poland
- 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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