Limited drug–drug interaction of elbasvir/grazoprevir for chronic hepatitis C

• Main Authors: Chun-Jen Liu, Kuo-Chih Tseng, Ching-Chu Lo, I-Hao Tseng, Pin-Nan Cheng
• Format: Article
• Language: English
• Published: Elsevier 2020-05-01
• Series: Journal of the Formosan Medical Association
• Subjects: Drug–drug interaction; Direct acting antivirals; Elbasvir/grazoprevir
• Online Access: http://www.sciencedirect.com/science/article/pii/S0929664619306667

Background/Purpose: The assessment of drug–drug interaction (DDI) is important not only for safety but also for maintaining the efficacy of direct acting antivirals in chronic hepatitis C (CHC). This study aims to evaluate DDI before and during elbasvir/grazoprevir (EBR/GZR) treatment. Methods: CHC patients who treated with EBR/GZR in five hospitals were enrolled. The patients' demographic data, comorbidities, concomitant medications taken before and during EBR/GZR were recorded. DDI was evaluated using a tool from the HEP Drug Interactions (www.hep-druginteractions.org) website. In addition to the evaluation of DDI for EBR/GZR, the virtual DDI of ledipasvir/sofosbuvir (LDV/SOF), sofosbuvir/velpatasvir (SOF/VEL) and glecaprevir/pibrentasvir (GLE/PIB) were evaluated. Degrees of DDI were classified as “do not co-administer”, “potential interaction”, and “potentially weak interaction”. Results: A total of 460 patients were enrolled. At baseline, 80.1% of patients had one or more comorbidities and 72.8% took one or more medications. Cardiovascular diseases (43.9%), gastrointestinal diseases (37.4%), and metabolic diseases (36.7%) were the three most common comorbidities. The prevalence of DDI before EBR/GZR treatment was 12.8% (59 patients). Among the same population, the prevalence of virtual DDI of SOF/VEL, GLE/PIB, and LDV/SOF were 38.5% (179 patients), 48.8% (220 patients), and 57.0% (262 patients), respectively. During EBR/GZR treatment, 167 patients (36.3%) took newly prescribed medications. One patient (0.2%) and seven patients (1/5%) exhibited do-not-co-administer and potential interaction with EBR/GZR, respectively. Conclusion: DDI was limited in treatment with EBR/GZR. DDI can occur upon the administering of a new medication during antiviral treatment and attention should be paid to it. Trial registration number: NCT03706222.