Increased Ribavirin Bioavailability Associated With Telaprevir Use in Hepatitis C Patients Treated With PEGylated -Interferon/Ribavirin/Telaprevir Triple Therapy
| Author | Pierre Pradat | en |
| Author | Victor Virlogeux | en |
| Author | Marianne Maynard | en |
| Author | Mathilde Leclercq | en |
| Author | Giorgiana Hatu | en |
| Author | Majid Amiri | en |
| Author | Fanny Lebosse | en |
| Author | Patrick Miailhes | en |
| Author | Fabien Zoulim | en |
| Author | Marie-Claude Gagnieu | en |
| Author | François Bailly | en |
| Issued Date | 2015-09-01 | en |
| Abstract | Background: Anemia is more frequent in patients receiving telaprevir with PEGylated interferon/ribavirin (PEG-IFN/RBV) than in those receiving PEG-IFN/RBV alone. Objectives: The objective was to measure the impact of telaprevir on RBV bioavailability and to assess the concomitant renal function. Materials and Methods: Thirty-seven hepatitis C virus (HCV) patients non-responders to a previous course of PEG-IFN/RBV therapy and re-treated with triple therapy combining PEG-IFN/RBV and telaprevir were analyzed. RBV bioavailability was measured before the triple therapy initiation, during telaprevir treatment at week (W) 4 and W8, and after telaprevir cessation (post W16). The renal function was assessed by estimating the glomerular filtration rate (eGFR). Results: At W4, RBV bioavailability, expressed as mg/L/daily dose/kg body weight, was significantly increased (median increase = 0.06 mg/L/dose/kg; P < 0.001). In parallel, the renal function was impaired with a mean eGFR decrease of -6.8 mL/minutes/1.73 m² (P = 0.109). Between W4 and W8, RBV bioavailability continued to increase (P < 0.001) but subsequently decreased slightly after telaprevir discontinuation with a concomitant restoration of the renal function (eGFR increase of 6.34 mL/minutes/1.73 m²). Conclusions: Our results indicated a reversible increase in RBV bioavailability after telaprevir exposure, which might be linked to the impairment of the GFR. This also suggests a RBV-telaprevir pharmacological interaction, a possible source of severe anemia observed under triple therapy. These results suggest that RBV pharmacological monitoring may be clinically relevant, especially in the context of first-generation HCV protease inhibitor-based therapy. | en |
| DOI | https://doi.org/10.5812/hepatmon.28879 | en |
| Keyword | Anemia | en |
| Keyword | Antiviral Agents | en |
| Keyword | Glomerular Filtration Rate | en |
| Keyword | Hepatitis C | en |
| Keyword | Ribavirin | en |
| Keyword | Telaprevir | en |
| Publisher | Brieflands | en |
| Title | Increased Ribavirin Bioavailability Associated With Telaprevir Use in Hepatitis C Patients Treated With PEGylated -Interferon/Ribavirin/Telaprevir Triple Therapy | en |
| Type | Brief Report | en |
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