CP-146 Drug interactions with direct acting antivirals for hepatitis C: What about in practice? pharmaceutical impact

2016 ◽  
Vol 23 (Suppl 1) ◽  
pp. A64.2-A65
Author(s):  
M Vancassel ◽  
C Jurado ◽  
F Eyvrard ◽  
S Houet ◽  
M Watier ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Drug Interactions ◽  
Direct Acting Antivirals ◽  
Direct Acting

scholarly journals Comedications and potential drug-drug interactions with direct-acting antivirals in hepatitis C patients on hemodialysis

2021 ◽  
Vol 27 (1) ◽  
pp. 186-196
Author(s):  
Po-Yao Hsu ◽  
Yu-Ju Wei ◽  
Jia-Jung Lee ◽  
Sheng-Wen Niu ◽  
Jiun-Chi Huang ◽  
...  
Keyword(s):  
Hepatitis C ◽  
Drug Interactions ◽  
Median Number ◽  
Lipid Lowering ◽  
Hcv Rna ◽  
Close Monitoring ◽  
Potential Drug ◽  
Direct Acting Antivirals ◽  
Potential Ddis ◽  
Direct Acting

Background/Aims: Direct‐acting antivirals (DAAs) have been approved for hepatitis C virus (HCV) treatment in patients with end-stage renal disease (ESRD) on hemodialysis. Nevertheless, the complicated comedications and their potential drug-drug interactions (DDIs) with DAAs might limit clinical practice in this special population.Methods: The number, class, and characteristics of comedications and their potential DDIs with five DAA regimens were analyzed among HCV-viremic patients from 23 hemodialysis centers in Taiwan.Results: Of 2,015 hemodialysis patients screened in 2019, 169 patients seropositive for HCV RNA were enrolled (mean age, 65.6 years; median duration of hemodialysis, 5.8 years). All patients received at least one comedication (median number, 6; mean class number, 3.4). The most common comedication classes were ESRD-associated medications (94.1%), cardiovascular drugs (69.8%) and antidiabetic drugs (43.2%). ESRD-associated medications were excluded from DDI analysis. Sofosbuvir/velpatasvir/voxilaprevir had the highest frequency of potential contraindicated DDIs (red, 5.6%), followed by glecaprevir/pibrentasvir (4.0%), sofosbuvir/ledipasvir (1.3%), sofosbuvir/velpatasvir (1.3%), and elbasvir/grazoprevir (0.3%). For potentially significant DDIs (orange, requiring close monitoring or dose adjustments), sofosbuvir/velpatasvir/voxilaprevir had the highest frequency (19.9%), followed by sofosbuvir/ledipasvir (18.2%), glecaprevir/pibrentasvir (12.6%), sofosbuvir/velpatasvir (12.6%), and elbasvir/grazoprevir (7.3%). Overall, lipid-lowering agents were the most common comedication class with red-category DDIs to all DAA regimens (n=62), followed by cardiovascular agents (n=15), and central nervous system agents (n=10).Conclusions: HCV-viremic patients on hemodialysis had a very high prevalence of comedications with a broad spectrum, which had varied DDIs with currently available DAA regimens. Elbasvir/grazoprevir had the fewest potential DDIs, and sofosbuvir/velpatasvir/voxilaprevir had the most potential DDIs.

Management of drug interactions with direct-acting antivirals in Dutch HIV/hepatitis C virus-coinfected patients: adequate but not perfect

HIV Medicine ◽  
2017 ◽  
Vol 19 (3) ◽  
pp. 216-226 ◽  
Author(s):  
EJ Smolders ◽  
C Smit ◽  
CTMM de Kanter ◽  
ASM Dofferhoff ◽  
JE Arends ◽  
...  
Keyword(s):  
Hepatitis C Virus ◽  
Hepatitis C ◽  
Drug Interactions ◽  
Direct Acting Antivirals ◽  
Direct Acting

scholarly journals Retrospective Evaluation on Patient Screening and Counseling Service on Direct-acting Antivirals Against Hepatitis C

2020 ◽  
Vol 15 (2) ◽  
pp. S99-103
Author(s):  
Bob Ka Him Wong ◽  
Gary Chung Hong Chong
Keyword(s):  
Hepatitis C ◽  
Hepatitis B ◽  
Drug Interactions ◽  
Healthcare Providers ◽  
Underlying Disease ◽  
Counseling Service ◽  
Direct Acting Antivirals ◽  
Hepatitis B Reactivation ◽  
Drug Wastage ◽  
Direct Acting

Objective: Drug-drug interactions and risk of hepatitis B reactivation potentially affect treatment outcomes of direct-acting antivirals (DAA) against hepatitis C. A comprehensive pharmacist screening and counseling service was implemented in a Hong Kong hospital, which aims to optimize the efficacy and safety of DAA therapy while minimizing the risk of drug wastage. The objective of the service review is to explore potential roles of pharmacist in hepatitis C management. Design: We retrospectively evaluate all cases under service from June 2017 to September 2018. Main outcome measures: Outcomes measured include drug-related problems (DRP) identified, treatment discontinuation and failure rates. Results: There were 44 cases under provision of service, all completed therapy except 1 died from underlying disease. 25 DRPs, predominantly categorized as drug-drug interactions, were documented. The interactions commonly involved acid-lowering agents. 1 case was noted with inadvertently lengthening of treatment duration. No cases of treatment failure or hepatitis B reactivation were reported. Conclusion: The safety concerns and high cost of DAA have created a new challenge to healthcare providers. Comprehensive screening and counseling by pharmacists are valuable to ensure safe and effective use of DAA, hence reducing unnecessary drug wastage.

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