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

Krzysztof Simon; Robert Flisiak; Tadeusz Łapiński; Ewa Janczewska; Marta Wawrzynowicz-Syczewska; Jerzy Jaroszewicz; Dorota Zarębska-Michaluk; Khalil Nazzal; Beata Bolewska; Jolanta Białkowska; Hanna Berak; Katarzyna Fleischer-Stępniewska; Krzysztof Tomasiewicz; Kornelia Karwowska; Karolina Rostkowska; Anna Piekarska; Olga Tronina; Grzegorz Madej; Aleksander Garlicki; Mariusz Łucejko; Arkadiusz Pisula; Ewa Karpińska; Wiesław Kryczka; Alicja Wiercińska-Drapało; Iwona Mozer-Lisewska; Maciej Jabłkowski; Andrzej Horban; Brygida Knysz; Magdalena Tudrujek; Waldemar Halota

doi:10.5114/ceh.2019.87634

eISSN: 2449-8238
ISSN: 2392-1099

Clinical and Experimental Hepatology

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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

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

DOI: https://doi.org/10.5114/ceh.2019.87634

Online publish date: 2019/09/05

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AMA

Simon KA, Flisiak R, Łapiński TW, et al. Effect of comedication on ombitasvir/paritaprevir/ritonavir ± dasabuvir ± ribavirin therapy in chronic hepatitis C – a real-world study. Clinical and Experimental Hepatology. 2019;5(3):215-223. doi:10.5114/ceh.2019.87634.

APA

Simon, K. A., Flisiak, R., Łapiński, T. W., Janczewska, E., Wawrzynowicz-Syczewska, M.,  & Jaroszewicz, J. et al. (2019). Effect of comedication on ombitasvir/paritaprevir/ritonavir ± dasabuvir ± ribavirin therapy in chronic hepatitis C – a real-world study. Clinical and Experimental Hepatology, 5(3), 215-223. https://doi.org/10.5114/ceh.2019.87634

Chicago

Simon, Krzysztof A, Robert Flisiak, Tadeusz W Łapiński, Ewa Janczewska, Marta Wawrzynowicz-Syczewska, Jerzy Jaroszewicz,  and Dorota Zarębska-Michaluk et al. 2019. "Effect of comedication on ombitasvir/paritaprevir/ritonavir ± dasabuvir ± ribavirin therapy in chronic hepatitis C – a real-world study". Clinical and Experimental Hepatology 5 (3): 215-223. doi:10.5114/ceh.2019.87634.

Harvard

Simon, K., Flisiak, R., Łapiński, T., Janczewska, E., Wawrzynowicz-Syczewska, M., Jaroszewicz, J., Zarębska-Michaluk, D., Nazzal, K., Bolewska, B., Białkowska, J., Berak, H., Fleischer-Stępniewska, K., Tomasiewicz, K., Karwowska, K., Rostkowska, K., Piekarska, A., Tronina, O., Madej, G., Garlicki, A., Łucejko, M., Pisula, A., Karpińska, E., Kryczka, W., Wiercińska-Drapało, A., Mozer-Lisewska, I., Jabłkowski, M., Horban, A., Knysz, B., Tudrujek, M.,  and Halota, W. (2019). Effect of comedication on ombitasvir/paritaprevir/ritonavir ± dasabuvir ± ribavirin therapy in chronic hepatitis C – a real-world study. Clinical and Experimental Hepatology, 5(3), pp.215-223. https://doi.org/10.5114/ceh.2019.87634

MLA

Simon, Krzysztof et al. "Effect of comedication on ombitasvir/paritaprevir/ritonavir ± dasabuvir ± ribavirin therapy in chronic hepatitis C – a real-world study." Clinical and Experimental Hepatology, vol. 5, no. 3, 2019, pp. 215-223. doi:10.5114/ceh.2019.87634.

Vancouver

Simon K, Flisiak R, Łapiński T, Janczewska E, Wawrzynowicz-Syczewska M, Jaroszewicz J et al. Effect of comedication on ombitasvir/paritaprevir/ritonavir ± dasabuvir ± ribavirin therapy in chronic hepatitis C – a real-world study. Clinical and Experimental Hepatology. 2019;5(3):215-223. doi:10.5114/ceh.2019.87634.

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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:

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

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