Open AccessThe majority of hepatitis C patients treated with direct acting antivirals are at risk for relevant drug‐drug interactions
Author(s) -
Smolders Elise J,
Berden Floor AC,
Kanter Clara TMM,
Kievit Wietske,
Drenth Joost PH,
Burger David M
Publication year - 2017
Publication title -
ueg journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.667
H-Index - 35
eISSN - 2050-6414
pISSN - 2050-6406
DOI - 10.1177/2050640616678151
Subject(s) - medicine , drug , dasabuvir , drug interaction , ritonavir , ombitasvir , pharmacology , hepatitis c , hepatitis c virus , virology , ribavirin , viral load , virus , antiretroviral therapy
Background Direct‐acting antivirals have improved treatment of chronic hepatitis C virus infection significantly. Direct‐acting antivirals inhibit/induce and can also be substrates of drug‐metabolising enzymes and transporters. This increases the risk for drug‐drug interactions. Objective The purpose of this study was to predict drug‐drug interactions with co‐medication used by hepatitis C virus‐infected patients. Methods We assembled a nationwide cohort of hepatitis C patients and collected cross‐sectional data on co‐medication use. We compiled a list of currently available direct‐acting antiviral regimens and cross‐checked for potential drug‐drug interactions with used co‐medication. Results The cohort included 461 patients of which 77% used co‐medication. We identified 260 drugs used as co‐medication. Antidepressants (7.4%), proton pump inhibitors (7.1%) and benzodiazepines (7.1%) were most frequently used. Of the patients, 60% were at risk for a clinically relevant drug‐drug interaction with at least one of the direct‐acting antiviral regimens. Interactions were most common with paritaprevir/ritonavir/ombitasvir/dasabuvir and least interactions were predicted with grazoprevir/elbasvir. Conclusion Co‐medication use is rich in frequency and diversity in chronic hepatitis C patients. The majority of patients are at risk for drug‐drug interactions which may affect efficacy or toxicity of direct‐acting antivirals or co‐medication. The most recently introduced direct‐acting antivirals are associated with a lower risk of drug‐drug interactions.