Real-world effectiveness of the combined treatment elbasvir/grazoprevir ± ribavirin in patients with hepatitis c virus genotype 1/4

• Autores: Juan Carlos del Río Valencia, Juan José Alcaraz Sánchez, Aranzazu Linares Alarcón, Isabel Muñoz Castillo
• Localización: European journal of clinical pharmacy: atención farmacéutica, ISSN 2385-409X, Vol. 21, Nº. 4, 2019, págs. 182-186
• Idioma: inglés
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• Resumen

  • Introduction and objective: Antiviral treatment for HCV infection has significantly improved since the advent of direct-acting antiviral (DAA), yet a number of issues remain unmet. There are very limited treatment options for patients with chronic kidney disease (CK.D), patients with resistance-associated substitutions (RAS) and patients with coadministered drugs due to complicated diseases. The combined treatment elbasvir (EBR) and grazoprevir (GZR) has consistently shown high rates of sustained virologic response (SVR) in patients with chronic HCV and GT 1 and 4. This regimen is currently one of the two licensed treatment, together with glecaprevir/pibrentasvir, used in individuals with advanced chronic kidney disease requiring hemodialysis. The aim of this analysis was to evaluate the effectiveness of EBR/GZR in real-world data. Method: Retrospective and observational study carried out from January 2017 to January 2019. Inclusion criteria: Patients with HCV infection treated with EBR/GZR for 12, 16 or 24 weeks during study period. Exclusion criteria: Patients from whom adequate clinical and/or analytical information was not available for further analysis. The variables collected were expressed as median (range) or mean and standard deviation. All analyses were performed by using SPSS v. 17. Results: 28 patients were analyzed achieving SVR 12 96.42% (27/28) of them. The patients with HCV genotype (GT) la or GT lb or GT4 achieved SVR 12, only one naive-non cirrhotic patient, with viral load higher than 800,000 IU/ml, did not get SVR 12. Patients diagnosed with chronic kidney failure were treated too. Concretely, three HCV-GTlb infected patients who suffered from stage 5 chronic kidney failure (<15 ml/min) and one patient from stage 4 (<30 ml/min) achieving SVR 12 all of them and maintained their renal function at the end of the treatment. Conclusion: The EBV/GZR regimen could be considered a therapeutic alternative to other combinations of DAA, in patients with genotype 1 and 4, both mono and coinfected with HIV, with and without cirrhosis and patients with chronic kidney disease. © 2019 Rasgo Editorial S.A.. All rights reserved.