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Librelotto CS, Souza APDE, Álvares-DA-Silva MR, Simon D, Dihl RR. Evaluation of the genetic toxicity of sofosbuvir and simeprevir with and without ribavirin in a human-derived liver cell line. AN ACAD BRAS CIENC 2021; 93:e20200632. [PMID: 34586319 DOI: 10.1590/0001-3765202120200632] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 07/03/2020] [Indexed: 11/22/2022] Open
Abstract
Direct-acting antivirals have revolutionized the treatment of chronic hepatitis C. Sofosbuvir and simeprevir are prescribed worldwide. However, there is a scarcity of information regarding their genotoxicity. Therefore, the present study assessed the cytotoxic and genotoxic effects of sofosbuvir and simeprevir, alone and combined with ribavirin. HepG2 cells were analyzed using the in vitro cytokinesis-block micronucleus cytome assay. Cells were treated for 24 h with sofosbuvir (0.011-1.511 mM), simeprevir (0.156-5.0 µM), and their combinations with ribavirin (0.250-4.0 mM). No significant differences were observed in the nuclear division cytotoxicity index, reflecting the absence of cytotoxic effects associated to sofosbuvir. However, the highest concentration of simeprevir showed a significant difference for the nuclear division cytotoxicity index. Moreover, significant results were observed for nuclear division cytotoxicity index in two combinations of sofosbuvir plus ribavirin and only in the highest combination of simeprevir plus ribavirin. Additionally, our results showed that sofosbuvir did not increase the frequency of chromosomal damage, but simeprevir significantly increased the frequency of micronuclei at the highest concentrations. The combination index demonstrated that both sofosbuvir and simeprevir produced antagonism to the genotoxic effects of ribavirin. In conclusion, our results showed that simeprevir, but not sofosbuvir, has genotoxic effects in HepG2 cells.
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Affiliation(s)
- Carina S Librelotto
- Programa de Pós-Graduação em Biologia Celular e Molecular Aplicada à Saúde, Universidade Luterana do Brasil (ULBRA), PPG Biologia Celular e Molecular Aplicada à Saúde, Av. Farroupilha, 8001, Prédio 22, 4° andar, 92425-900 Canoas, RS, Brazil
| | - Ana Paula DE Souza
- Programa de Pós-Graduação em Biologia Celular e Molecular Aplicada à Saúde, Universidade Luterana do Brasil (ULBRA), PPG Biologia Celular e Molecular Aplicada à Saúde, Av. Farroupilha, 8001, Prédio 22, 4° andar, 92425-900 Canoas, RS, Brazil
| | - Mário R Álvares-DA-Silva
- Programa de Pós-Graduação Ciências em Gastroenterologia e Hepatologia, Universidade Federal do Rio Grande do Sul (UFRGS), Hospital das Clínicas de Porto Alegre, Rua Ramiro Barcelos, 2350, Santa Cecilia, 90035-007 Porto Alegre, RS, Brazil
| | - Daniel Simon
- Programa de Pós-Graduação em Biologia Celular e Molecular Aplicada à Saúde, Universidade Luterana do Brasil (ULBRA), PPG Biologia Celular e Molecular Aplicada à Saúde, Av. Farroupilha, 8001, Prédio 22, 4° andar, 92425-900 Canoas, RS, Brazil
| | - Rafael R Dihl
- Programa de Pós-Graduação em Biologia Celular e Molecular Aplicada à Saúde, Universidade Luterana do Brasil (ULBRA), PPG Biologia Celular e Molecular Aplicada à Saúde, Av. Farroupilha, 8001, Prédio 22, 4° andar, 92425-900 Canoas, RS, Brazil
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2
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Aboushady M, Alwassief A, Abdelrazik M, Ziada D, Shahba H, Elmestikawy A, Elbahrawy A. Retreatment of Egyptian Chronic Hepatitis C Patients Not Responding to Pegylated Interferon and Ribavirin Dual Therapy. J Interferon Cytokine Res 2019; 39:539-546. [PMID: 31173550 DOI: 10.1089/jir.2019.0041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
In the current study, we aimed to assess the efficacy of different Sofosbuvir (SOF)-based antiviral regimens available in Egypt in the treatment of Pegylated interferon/Ribavirin (PEG-INF/RBV)-experienced chronic hepatitis C virus (HCV) patients. Two hundred fifty-eight patients experienced with PEG-INF/RBV, and 1,283 naive patients were included in the study. The patients received one of the following 3 regimens for 12 weeks; PEG-INF/SOF, Simeprevir/SOF (SIM/SOF), and Daclatasvir/SOF (DCV/SOF). The endpoint was a sustained virological response 12 weeks (SVR12) after the end of the treatment. SVR12, treatment failure, and relapse were assessed. Moreover, predictors of SVR12 were analyzed. The mean age of treatment-experienced and treatment-naive patients was 51.11 ± 5.84 years and 50.04 ± 5.97 years, respectively. Treatment-experienced patients included 132 (51.16%) males and 126 (48.83%) females. Treatment-naive patients included 709 (55.26%) males and 574 (44.73%) females. The SVR12, treatment failure and treatment relapse rates in treatment-experienced versus treatment-naive patients were 91.1% versus 96.8%, 0.8% versus 0.9%, and 8.9% versus 2.7%, respectively. The SIM/SOF regimen provoked a ubiquitous high SVR12 in both treatment-experienced and -naive patients. A SIM/SOF regimen provokes the highest SVR12 in PEG-INF/RBV-experienced chronic HCV patients. Retreatment with PEG-INF/SOF in PEG-INF/RBV-experienced chronic HCV patients has a high probability of treatment failure.
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Affiliation(s)
| | - Ahmed Alwassief
- Department of Internal Medicine, Al-Azhar University, Cairo, Egypt
| | - Mohamed Abdelrazik
- Department of Internal Medicine, Kafr Elsheikh Liver Research Center, Kafr Elsheikh, Egypt
| | - Dina Ziada
- Deartment of Tropical Medicine and Infectious Diseases, Tanta University, Tanta, Egypt
| | - Hossam Shahba
- Department of Internal Medicine, Al-Azhar University, Cairo, Egypt
| | - Amr Elmestikawy
- Department of Internal Medicine, Al-Azhar University, Cairo, Egypt
| | - Ashraf Elbahrawy
- Department of Internal Medicine, Al-Azhar University, Cairo, Egypt
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3
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Campione E, Dattola A, Di Prete M, Di Paolo D, Ferlosio A, Orlandi A, Bianchi L. Sofosbuvir induced leucocytoclasic vasculitis: a case report. BMC DERMATOLOGY 2019; 19:6. [PMID: 31096980 PMCID: PMC6524249 DOI: 10.1186/s12895-019-0086-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2018] [Accepted: 04/30/2019] [Indexed: 11/16/2022]
Abstract
Background We describe a case of leucocytoclasic vasculitis induced by Sofosbuvir and its disappearence after the end of the therapy. The hepatitis C virus, firstly described in 1989, is a major global health problem, with high morbidity and mortality. We observed a temporal relationship between the treatment and the onset of vasculitis. We emphasize the multidisciplinary approach to the patients with liver disease to improve the quality of life of these patients. Case presentation A 53-year-old Caucasian man with a history of hepatitis C virus genotype 1 infection was examined at our Department of Dermatology for the occurrence of palpable purpura. The patient referred that the first appearance of the dermatoses was about one month after initiation of therapy with Sofosbuvir for hepatitis C. Conclusions Vasculitis appeared after the beginning of Sofosbuvir and, even though it was treated with different medications proved to be effective, it disappeared only after the conclusion of the therapy, giving a strong evidence to be a drug eruption.
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Affiliation(s)
- Elena Campione
- Department of Dermatology, University of Rome Tor Vergata, Viale Oxford, 81, 00133, Rome, Italy.
| | - Annunziata Dattola
- Department of Dermatology, University of Rome Tor Vergata, Viale Oxford, 81, 00133, Rome, Italy
| | - Monia Di Prete
- Department of Anatomic Pathology, University of Rome Tor Vergata, Viale Oxford, 81, 00133, Rome, Italy
| | | | - Amedeo Ferlosio
- Department of Anatomic Pathology, University of Rome Tor Vergata, Viale Oxford, 81, 00133, Rome, Italy
| | - Augusto Orlandi
- Department of Anatomic Pathology, University of Rome Tor Vergata, Viale Oxford, 81, 00133, Rome, Italy
| | - Luca Bianchi
- Department of Dermatology, University of Rome Tor Vergata, Viale Oxford, 81, 00133, Rome, Italy
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4
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Gomes LO, Teixeira MR, Rosa JAD, Feltrin AA, Rodrigues JPV, Vecchi MD, Carneiro JMM, Noblat LDACB, Chachá SGF, Martinelli ADLC, Pereira LRL, Silveira MPT, Blatt CR, Farias MR. Hepatitis C in Brazil: lessons learned with boceprevir and telaprevir. Rev Inst Med Trop Sao Paulo 2018; 60:e29. [PMID: 29972466 PMCID: PMC6029893 DOI: 10.1590/s1678-9946201860029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 03/28/2018] [Indexed: 01/09/2023] Open
Abstract
In 2012, the first-generation protease inhibitors telaprevir (TVR) and boceprevir (BOC) were introduced in the Brazilian health system for treatment of chronic hepatitis C, after their approval by the National Committee for Health Technology Incorporation (CONITEC). However, these medicines were discontinued in 2015. The short period of use in therapy and their high cost require a discussion about the consequences for patients and for the health system of the early incorporation of new therapies. The article presents a qualitative analysis of the incorporation process of both medications in Brazil and the results of a multicenter study that included patients treated with BOC or TVR between January 2011 and December 2015 in five Brazilian cities. The study included 855 patients (BOC: n=247) and (TVR: n=608). The document analysis showed that CONITEC's decision to incorporate BOC and TVR was based on results of phase III clinical trials that compared sustained virologic response (SVR) rates of patients treated with BOC and TVR with rates of those that received placebo. However, these studies included a low percentage of cirrhotic patients. The SVR rates observed in this multicenter study were worse than clinical trials pointed out (BOC: 45.6%; TVR: 51.8%), but similar to those achieved with previously adopted therapies. The discontinuation rate due to adverse events was (BOC: 15.4%; TVR: 12.7%). Based on these unsatisfactory results, the study brings a discussion that goes beyond the therapy outcomes, exploring the incorporation of these high-cost medicines and the related decision-making process, contributing to future decisions in medicine policies and in the treatment of chronic hepatitis C.
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Affiliation(s)
- Lenyta Oliveira Gomes
- Departamento de Ciências Farmacêuticas, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Marina Rodrigues Teixeira
- Departamento de Ciências Farmacêuticas, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Júnior André da Rosa
- Departamento de Ciências Farmacêuticas, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | | | - João Paulo V Rodrigues
- Departamento de Ciências Farmacêuticas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Mariane D'Avila Vecchi
- Faculdade de Medicina, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | | | | | - Silvana Gama F Chachá
- Departamento de Medicina, Universidade Federal de São Carlos, São Carlos, São Paulo, Brazil
| | - Ana de Lourdes C Martinelli
- Departamento de Clínica Médica, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Leonardo Regis L Pereira
- Departamento de Ciências Farmacêuticas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Marysabel Pinto T Silveira
- Departamento de Fisiologia e Farmacologia, Instituto de Biologia, Universidade Federal de Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Carine Raquel Blatt
- Departamento de Farmacociências, Universidade Federal de Ciências da Saúde de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Mareni Rocha Farias
- Departamento de Ciências Farmacêuticas, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil
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Sulkowski MS, Feld JJ, Lawitz E, Felizarta F, Corregidor AM, Khalid O, Ghalib R, Smith WB, Van Eygen V, Luo D, Vijgen L, Gamil M, Kakuda TN, Ouwerkerk-Mahadevan S, Van Remoortere P, Beumont M. Efficacy and safety of 6 or 8 weeks of simeprevir, daclatasvir, sofosbuvir for HCV genotype 1 infection. J Viral Hepat 2018; 25:631-639. [PMID: 29274193 DOI: 10.1111/jvh.12853] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 11/22/2017] [Indexed: 12/12/2022]
Abstract
The phase 2, open-label ACCORDION (ClinicalTrials.gov: NCT02349048) study investigated the efficacy, safety and pharmacokinetics of a 6- or 8-week regimen of simeprevir, daclatasvir and sofosbuvir in treatment-naïve patients with chronic hepatitis C virus (HCV) genotype (GT) 1 infection and either early-stage fibrosis or compensated cirrhosis. Patients were assigned to treatment groups according to their fibrosis stage. Early-stage fibrosis: simeprevir 150 mg, daclatasvir 60 mg, sofosbuvir 400 mg once daily for 6 weeks; compensated cirrhosis: same regimen for 8 weeks. The primary endpoint was sustained virologic response 12 weeks after the end of treatment (SVR12). Safety, tolerability and pharmacokinetics of simeprevir, daclatasvir and sofosbuvir were investigated. Sixty-eight patients were treated (6-week group: n = 59; 8-week group: n = 9). SVR12 was achieved by 86.4% (51/59) of patients with early-stage fibrosis and by 100% (9/9) of patients with cirrhosis. The main reason for not achieving SVR12 in the 6-week group was viral relapse (11.9%; 7/59). One patient had on-treatment failure due to an early withdrawal (lost to follow-up due to incarceration). One patient with SVR12 in the 6-week group had a late viral relapse at post-treatment week 24. No clinically significant drug-drug interactions were observed. Adverse events were reported in 63.2% of patients (43/68) and were mainly grade 1/2. None of these led to treatment discontinuation. The 3 direct-acting antiviral regimens of simeprevir, daclatasvir and sofosbuvir were safe and well tolerated in treatment-naïve, HCV GT1-infected patients with early-stage fibrosis or compensated cirrhosis.
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Affiliation(s)
- M S Sulkowski
- Divisions of Infectious Diseases and Hepatology/Gastroenterology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - J J Feld
- Toronto Center for Liver Disease, Toronto General Hospital, Toronto, ON, Canada
| | - E Lawitz
- Texas Liver Institute, University of Texas Health, San Antonio, TX, USA
| | | | | | - O Khalid
- Digestive Health Specialists, Winston-Salem, NC, USA
| | - R Ghalib
- North Texas GI Surgery Center, Arlington, TX, USA
| | - W B Smith
- NOCCR/VRG, University of Tennessee Medical Center, Knoxville, TN, USA
| | - V Van Eygen
- Janssen Research and Development, Janssen Pharmaceutica NV, Beerse, Belgium
| | - D Luo
- Janssen Pharmaceuticals, LLC, Titusville, NJ, USA
| | - L Vijgen
- Janssen Research and Development, Janssen Pharmaceutica NV, Beerse, Belgium
| | - M Gamil
- Janssen Research and Development, Janssen Pharmaceutica NV, Beerse, Belgium
| | - T N Kakuda
- Alios BioPharma, Inc. part of the Janssen Pharmaceutical Companies, South San Francisco, CA, USA
| | | | | | - M Beumont
- Janssen Research and Development, Janssen Pharmaceutica NV, Beerse, Belgium
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6
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Iqbal S, Yousuf MH, Yousaf MI. Dramatic response of hepatitis C patients chronically infected with hepatitis C virus genotype 3 to sofosbuvir-based therapies in Punjab, Pakistan: A prospective study. World J Gastroenterol 2017; 23:7899-7905. [PMID: 29209131 PMCID: PMC5703919 DOI: 10.3748/wjg.v23.i44.7899] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 09/06/2017] [Accepted: 09/13/2017] [Indexed: 02/07/2023] Open
Abstract
AIM To prospectively evaluate the efficacy of sofobuvir (SOF) in hepatitis C patients infected with hepatitis C virus (HCV) genotype 3 in Pakistan.
METHODS The present study was performed with the coordination of gastroenterology and pathology departments of Shalamar Hospital Lahore from August 2014 to May 2016. The total number of patients included in this study was 1375 and all of them were infected with HCV genotype 3. On the basis of drug combinations, all the patients were separated into two groups. The first group of patients was treated for 24 wk with SOF (Sovaldi® by Gilead Sciences) plus ribavirin (RBV) [Ribazol® by Getz Pharma Pakistan (PVT) Ltd], while the patients of the second group were treated with SOF + RBV + pegylated-interferon (pegIFN) alfa-2a (Ropegra by Roach) for 12 wk. HCV genotyping and viral load measurement were performed on fully automated Abbott Real-Time PCR system (Abbott m24sp automated nucleic acid extraction system and Abbott m2000rt amplification system; abbott Molecular, Des Plaines, IL, United States). For the assessment of sustained virological response (SVR), all HCV RNA negative patients were followed for 12 weeks after the treatment completion. Any patient with less than 12 IU/mL viral load after 12 wk of treatment completion was considered as a sustained virological responder (SVR-12).
RESULTS A total of 1375 patients chronically infected with HCV genotype 3 were treated with two drug combinations SOF + RBV and SOF + RBV + pegIFN alfa-2a. On the basis of these drug combinations, patients were divided into two groups (first and second). Overall SVR-12 was excellent in both groups (99.17% and 97.91%). Older patients (> 40 years) of second group showed lower SVR-12 (93.46%) compared to first group older patients (98.79%), while in the younger patients of both groups, the SVR-12 rate was almost the same (99.54% in first group and 99.05% in second group). No such difference regarding SVR-12 rate was seen in males and females of first group patients (99.68% and 98.88%, respectively), while in second group the males were found to be better responders compared to females (98.96% and 95%). The SVR-12 rate in previously treated patients of first group was better (99.34%) than second group (93.70%), while naïve patients of second group were marginally better responders (99.25%) than first group (97.80%). Rapid viral response at week-4 was found to be a very effective predictor for assessing the SVR rate at this stage of therapy in both groups. Headache, anemia and fatigue were common side effects in both groups either treated with SOF + RBV or SOF + RBV + pegIFN alfa-2a, while the overall percentage of the side effects was higher in second group.
CONCLUSION The remarkable SVR response rate of HCV genotype 3 infected patients to SOF provided a new way to look forward to eliminate hepatitis C from our region.
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Affiliation(s)
- Sajjad Iqbal
- Department of Pathology, Shalamar Hospital, Lahore 54840, Pakistan
| | - Muhammad Haroon Yousuf
- Department of Gastroenterology and Hepatology, Shalamar Hospital, Lahore 54840, Pakistan
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7
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Louie V, Latt NL, Gharibian D, Sahota A, Yanny BT, Mittal R, Bider-Canfield Z, Cheetham TC. Real-World Experiences With a Direct-Acting Antiviral Agent for Patients With Hepatitis C Virus Infection. Perm J 2017; 21:16-096. [PMID: 28368787 DOI: 10.7812/tpp/16-096] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
CONTEXT Traditional hepatitis C virus treatment was limited by low cure rates, side effects, and stringent monitoring requirements. Sofosbuvir, a direct-acting antiviral agent with a cure rate of 96%, was introduced in 2013. However, trials frequently excluded patients with advanced liver disease and prior treatment experience. This study aims to elucidate the real-world cure rates and sofosbuvir safety profile. METHODS A retrospective cohort study was conducted at Kaiser Permanente Southern California involving patients with hepatitis C virus who received sofosbuvir treatment. Patients age 18 years and older were included, and pregnant patients were excluded. The primary end point was sustained virologic response at 12 weeks posttreatment. Secondary end points were safety and medication adherence. Multiple logistic regression analysis was used to compare patients with genotypes 1 and 2 infections. RESULTS Of the 213 study patients, 42.3% had cirrhosis, and 38% were treatment-experienced. Most patients (69.5%) received dual therapy (sofosbuvir + ribavirin), whereas the remainder (30.5%) received triple therapy (sofosbuvir + ribavirin + interferon). The overall rate of sustained virologic response at 12 weeks posttreatment rate was 72.9% for genotype 1 infection, 64.7% in the treatment-experienced subgroup, and 66.7% in the cirrhosis subgroup. Rates of sustained virologic response at 12 weeks posttreatment for genotypes 2 and 3 were 90.8% and 55%, respectively. Most patients experienced anemia and fatigue. Women and patients with a lower baseline viral load were statistically more likely to be cured. CONCLUSION Real-world cure rates were similar to rates seen in clinical trials for genotype 2 infection and lower for genotype 1 infection. Patients with genotype 1 and 3 infection did better with triple therapy compared with dual therapy. Patients tolerated therapy well with side effects, serious adverse events, and discontinuation rates similar to clinical trials. Women and patients with lower baseline hepatitis C viral load were more likely to achieve sustained virological response at 12 weeks posttreatment.
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Affiliation(s)
- Vincent Louie
- Ambulatory Care Pharmacist at the Los Angeles Medical Center in CA.
| | - Nyan L Latt
- Gastroenterology Fellow at the Los Angeles Medical Center in CA.
| | - Derenik Gharibian
- Clinical Operations Manager for Pharmacy Operations at the Los Angeles Medical Center in CA.
| | | | - Beshoy T Yanny
- Gastroenterology Fellow at the Los Angeles Medical Center in CA.
| | - Rasham Mittal
- Gastroenterology Fellow at the Los Angeles Medical Center in CA.
| | - Zoe Bider-Canfield
- Biostatistician in the Department of Research and Evaluation of Kaiser Permanente Southern California in Pasadena.
| | - T Craig Cheetham
- Researcher in the Department of Research and Evaluation for Kaiser Permanente Southern California in Pasadena
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8
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Perumalswami PV, Patel N, Bichoupan K, Ku L, Yalamanchili R, Harty A, Motamed D, Khaitova V, Chang C, Grewal P, Liu L, Schiano TD, Woodward M, Dieterich DT, Branch AD. High baseline bilirubin and low albumin predict liver decompensation and serious adverse events in HCV-infected patients treated with sofosbuvir-containing regimens. J Viral Hepat 2016; 23:667-76. [PMID: 26989855 DOI: 10.1111/jvh.12530] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 02/11/2016] [Indexed: 01/05/2023]
Abstract
To conduct surveillance and determine the safety profile of new hepatitis C virus treatments in real-world clinical practice. Hepatic decompensation and other serious adverse events were investigated in an observational cohort study of 511 patients treated with regimens containing sofosbuvir, December 2013-June 2014. Among 499 previously stable patients (no history of hepatic decompensation during the previous 12 months), a nested case-control study was performed to identify predictors of decompensation/serious adverse event. Cases and controls were matched 1:5 based on treatment regimen and duration. Matched conditional logistic regression was used for analysis. Providers scored the likelihood that events were treatment-related (scale = 0-4). The cumulative incidence of decompensation/events was 6.4% for the total cohort. Among 499 previously stable patients, the incidence of decompensation/events was 4.5%; the mortality rate was 0.6%. Sixteen of the 499 experienced one or more serious complications considered to be at least potentially treatment-related, and the sustained virological response rate was 7/16 (44%). Two cases, both on sofosbuvir/simeprevir (without interferon or ribavirin), had complications consistent with autoimmune events (score 3, 'likely treatment-related'), and one experienced a flare of autoimmune hepatitis. Compared to controls, cases had higher baseline median model for end-stage liver disease scores (14 vs 8, P < 0.01). Decompensation/events was independently associated with lower baseline albumin (OR = 0.12/g/dL, P = 0.01) and higher total bilirubin (OR = 4.31/mg/dL, P = 0.01). Reduced hepatic function at baseline increased the risk of liver decompensation/events.
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Affiliation(s)
- P V Perumalswami
- Division of Liver Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Recanati Miller Transplant Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - N Patel
- Division of Liver Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - K Bichoupan
- Division of Liver Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - L Ku
- Division of Liver Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - R Yalamanchili
- Division of Liver Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - A Harty
- Division of Liver Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - D Motamed
- Division of Liver Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Recanati Miller Transplant Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - V Khaitova
- Division of Liver Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Recanati Miller Transplant Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - C Chang
- Division of Liver Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Recanati Miller Transplant Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - P Grewal
- Division of Liver Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Recanati Miller Transplant Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - L Liu
- Division of Liver Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Recanati Miller Transplant Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - T D Schiano
- Division of Liver Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, USA.,Recanati Miller Transplant Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - M Woodward
- Nuffield Department of Population Health, The George Institute for Global Health, University of Oxford, Oxford, UK.,The George Institute for Global Health, University of Sydney, Sydney, NSW, Australia
| | - D T Dieterich
- Division of Liver Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - A D Branch
- Division of Liver Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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9
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Nakamura M, Kanda T, Haga Y, Sasaki R, Wu S, Nakamoto S, Yasui S, Arai M, Imazeki F, Yokosuka O. Sofosbuvir treatment and hepatitis C virus infection. World J Hepatol 2016; 8:183-90. [PMID: 26839641 PMCID: PMC4724580 DOI: 10.4254/wjh.v8.i3.183] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 11/27/2015] [Accepted: 01/05/2016] [Indexed: 02/06/2023] Open
Abstract
Hepatitis C virus (HCV) infection is a serious problem worldwide. The use of interferon-based therapy has made HCV eradication challenging. The recent appearance of direct-acting antiviral agents (DAAs) has changed HCV therapy. Combining the use of DAAs with peginterferon and ribavirin has improved treatment efficacy. Furthermore, the combination of different orally administered DAAs has enabled interferon-free therapy with much higher efficacy and safety. In particular, sofosbuvir, a nucleotide-based NS5B inhibitor, prevents HCV RNA synthesis by acting as a "chain terminator". Treatment with sofosbuvir has attained an extremely high rate of sustained virologic response. The current review summarizes the efficacy and safety of sofosbuvir therapy.
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Affiliation(s)
- Masato Nakamura
- Masato Nakamura, Tatsuo Kanda, Yuki Haga, Reina Sasaki, Shuang Wu, Shingo Nakamoto, Shin Yasui, Makoto Arai, Fumio Imazeki, Osamu Yokosuka, Department of Gastroenterology and Nephrology, Chiba University, Graduate School of Medicine, Chiba 260-8670, Japan
| | - Tatsuo Kanda
- Masato Nakamura, Tatsuo Kanda, Yuki Haga, Reina Sasaki, Shuang Wu, Shingo Nakamoto, Shin Yasui, Makoto Arai, Fumio Imazeki, Osamu Yokosuka, Department of Gastroenterology and Nephrology, Chiba University, Graduate School of Medicine, Chiba 260-8670, Japan
| | - Yuki Haga
- Masato Nakamura, Tatsuo Kanda, Yuki Haga, Reina Sasaki, Shuang Wu, Shingo Nakamoto, Shin Yasui, Makoto Arai, Fumio Imazeki, Osamu Yokosuka, Department of Gastroenterology and Nephrology, Chiba University, Graduate School of Medicine, Chiba 260-8670, Japan
| | - Reina Sasaki
- Masato Nakamura, Tatsuo Kanda, Yuki Haga, Reina Sasaki, Shuang Wu, Shingo Nakamoto, Shin Yasui, Makoto Arai, Fumio Imazeki, Osamu Yokosuka, Department of Gastroenterology and Nephrology, Chiba University, Graduate School of Medicine, Chiba 260-8670, Japan
| | - Shuang Wu
- Masato Nakamura, Tatsuo Kanda, Yuki Haga, Reina Sasaki, Shuang Wu, Shingo Nakamoto, Shin Yasui, Makoto Arai, Fumio Imazeki, Osamu Yokosuka, Department of Gastroenterology and Nephrology, Chiba University, Graduate School of Medicine, Chiba 260-8670, Japan
| | - Shingo Nakamoto
- Masato Nakamura, Tatsuo Kanda, Yuki Haga, Reina Sasaki, Shuang Wu, Shingo Nakamoto, Shin Yasui, Makoto Arai, Fumio Imazeki, Osamu Yokosuka, Department of Gastroenterology and Nephrology, Chiba University, Graduate School of Medicine, Chiba 260-8670, Japan
| | - Shin Yasui
- Masato Nakamura, Tatsuo Kanda, Yuki Haga, Reina Sasaki, Shuang Wu, Shingo Nakamoto, Shin Yasui, Makoto Arai, Fumio Imazeki, Osamu Yokosuka, Department of Gastroenterology and Nephrology, Chiba University, Graduate School of Medicine, Chiba 260-8670, Japan
| | - Makoto Arai
- Masato Nakamura, Tatsuo Kanda, Yuki Haga, Reina Sasaki, Shuang Wu, Shingo Nakamoto, Shin Yasui, Makoto Arai, Fumio Imazeki, Osamu Yokosuka, Department of Gastroenterology and Nephrology, Chiba University, Graduate School of Medicine, Chiba 260-8670, Japan
| | - Fumio Imazeki
- Masato Nakamura, Tatsuo Kanda, Yuki Haga, Reina Sasaki, Shuang Wu, Shingo Nakamoto, Shin Yasui, Makoto Arai, Fumio Imazeki, Osamu Yokosuka, Department of Gastroenterology and Nephrology, Chiba University, Graduate School of Medicine, Chiba 260-8670, Japan
| | - Osamu Yokosuka
- Masato Nakamura, Tatsuo Kanda, Yuki Haga, Reina Sasaki, Shuang Wu, Shingo Nakamoto, Shin Yasui, Makoto Arai, Fumio Imazeki, Osamu Yokosuka, Department of Gastroenterology and Nephrology, Chiba University, Graduate School of Medicine, Chiba 260-8670, Japan
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D'Ambrosio R, Aghemo A, Colombo M. Assessing safety and efficacy of sofosbuvir for the treatment of hepatitis C. Expert Opin Drug Saf 2015; 14:473-84. [PMID: 25645644 DOI: 10.1517/14740338.2015.1009035] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
INTRODUCTION IFN-free regimens with direct antiviral agents (DAAs) against hepatitis C virus (HCV) are likely to greatly expand patients' access and response to hepatitis C therapy, while safety and tolerability of treatments seem substantially improved. Sofosbuvir (SOF), a NS5B nucleotide polymerase inhibitor with pan-genotypic activity and a high-barrier to resistance, has been approved by FDA and EMA in an all oral combination therapy for chronic hepatitis C with ribavirin (RBV) alone, or in combination with either pegylated interferon/RBV or other DAAs. AREAS COVERED This paper provides an overview of SOF-based therapy in chronic hepatitis C as it emerges from the published clinical trials. Data on special populations are included (i.e., decompensated patients, patients on liver transplant waiting lists, patients with renal impairment). The data has been analyzed according to the different HCV-genotypes and comprehensively covers both safety and efficacy treatment profiles. EXPERT OPINION Clinical trials have highlighted the safety and efficacy of SOF-based regimens, leading to the rapid approval of this therapy and its incorporation in the recommendations of the international societies on treatment of HCV infection. However, additional data are still needed to optimize both combination therapies' efficacy and duration in some categories of patients who have been under-represented in the registration trials.
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Affiliation(s)
- Roberta D'Ambrosio
- Università degli Studi di Milano, Division of Gastroenterology and Hepatology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico , Milano, Via F. Sforza 35, 20122 Milan , Italy +39 0255035432 ; +39 0250320410 ;
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