Comorbidities, concomitant medications and potential drug-drug interactions with interferon-free direct-acting antiviral agents in hepatitis C patients in Taiwan.

Abstract

BACKGROUND:

While direct-acting antivirals have been approved for treating hepatitis C, the guidelines highlight the importance of considering potential drug-drug interactions between DAAs and concomitant medications.

AIM:

To assess comorbidity prevalence, concomitant medication use and potential drug-drug interactions between DAAs and concomitant medications for hepatitis C patients in Taiwan.

METHODS:

This cross-sectional study enrolled 822 patients from May to August 2016 in Taiwan. Patient demographics, comorbidities and concomitant medications were evaluated by physician surveys.

RESULTS:

A total of 709 (86.3%) patients had ≥1 comorbidity; the most prevalent comorbidity categories were diseases of the digestive system (40.1%), circulatory system (38.7%) and endocrine/nutritional/metabolic diseases (35.2%). Elderly patients had more comorbidities. A total of 622 (75.7%) patients received ≥1 concomitant medication; the average number of concomitant medications was 3.2. The most common concomitant medication classes were cardiovascular (34.4%), gastrointestinal (25.7%) and central nervous system drugs (22.7%). Among patients without cirrhosis or with compensated cirrhosis, contraindications were most prevalent with paritaprevir/ritonavir/ombitasvir plus dasabuvir, daclatasvir/asunaprevir and glecaprevir/pibrentasvir (13.3%, 6.0% and 5.4% respectively), and least prevalent with sofosbuvir, sofosbuvir/daclatasvir, sofosbuvir/ledipasvir and sofosbuvir/velpatasvir (0.8%, 1.3%, 1.4% and 2.1% respectively). Sofosbuvir-based regimens had no contraindications in patients with decompensated cirrhosis.

CONCLUSION:

Our population represented an elderly demographic, with a high prevalence of comorbidities and widespread use of concomitant medications. The potential drug-drug interactions between these concomitant medications and DAA regimens differed, with the fewest potential interactions with sofosbuvir-based regimens.

• Authors: Chen-Hua Liu, Ming-Lung Yu, Cheng-Yuan Peng, Tsai-Yuan Hsieh, Yi-Hsiang Huang, Wei-Wen Su, Pin-Nan Cheng, Chih-Lin Lin, Ching-Chu Lo, Chi-Yi Chen, Jyh-Jou Chen, Qian Ma, Craig Brooks-Rooney, Jia-Horng Kao
• Journal: Alimentary pharmacology & therapeutics (Aliment Pharmacol Ther) Vol. 48 Issue 11-12 Pg. 1290-1300 (12 2018) ISSN: 1365-2036 [Electronic] England
• PMID: 30362139 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2018 John Wiley & Sons Ltd.

Chemical References

• Anti-Infective Agents
• Antiviral Agents
• Benzimidazoles
• Cardiovascular Agents
• Fluorenes
• ledipasvir, sofosbuvir drug combination
• Interferons
• Uridine Monophosphate
• Sofosbuvir

Topics

• Aged
• Anti-Infective Agents (metabolism, therapeutic use)
• Antiviral Agents (metabolism, therapeutic use)
• Benzimidazoles (metabolism, therapeutic use)
• Cardiovascular Agents (metabolism, therapeutic use)
• Comorbidity
• Cross-Sectional Studies
• Drug Interactions (physiology)
• Female
• Fluorenes (metabolism, therapeutic use)
• Hepatitis C, Chronic (drug therapy, epidemiology, metabolism)
• Humans
• Interferons (metabolism, therapeutic use)
• Male
• Middle Aged
• Prospective Studies
• Sofosbuvir (metabolism, therapeutic use)
• Taiwan (epidemiology)
• Uridine Monophosphate (analogs & derivatives, metabolism, therapeutic use)