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. 2019 Sep;5(3):215-223.
doi: 10.5114/ceh.2019.87634. Epub 2019 Sep 5.

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
Affiliations

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

Krzysztof Adam Simon et al. Clin Exp Hepatol. 2019 Sep.

Abstract

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.

PubMed Disclaimer

Conflict of interest statement

The writing of this paper was funded by AbbVie.

Figures

Fig. 1
Fig. 1
Number of concomitant medications used by the patients
Fig. 2
Fig. 2
Proportion of patients requiring modification of current treatment prior to the initiation of/during OBV/PTV/r ± DSV ± RBV therapy
Fig. 3
Fig. 3
Sustained virologic response rates across the three subgroups. A) No comedications. B) 1-5 comedications. C) ≥ 5 comedications
Fig. 4
Fig. 4
HCV RNA dynamics in the three subgroups during treatment and follow-up. A) No comedications. *data available for 18/69 patients; **data available for 24/69 patients; ***data available for 59/69 patients. B) 1-5 comedications. *data available for 30/107 patients; **data available for 44/107 patients; ***data available for 96/107 patients. C) ≥ 5 comedications. *data available for 11/33 patients; **data available for 16/33 patients; ***data available for 31/33 patients
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