Background Boceprevir has been linked with high rates of anaemia in patients with HCV infection. Anaemia management strategies (AMS) are strongly recommended in order to achieve therapeutic success.
Purpose To describe AMS in HCV-infected patients who are on triple therapy that includes boceprevir.
Materials and methods We conducted a retrospective observational study. Medical records of patients on boceprevir between 01/2012–05/2013 in a tertiary hospital were reviewed. Patients were included if they were ≥18 years and had already finished their HCV treatment. Demographic and laboratory data were recorded from the start of the HCV treatment. The following data related to AMS were collected during the HCV treatment: number of ribavirin dose reductions, minimum ribavirin dose prescribed, use of recombinant human erythropoietin (rh-EPO) and/or granulocyte colony-stimulating factor (G-CSF). The chi-squared test was performed to examine the role of AMS on the incidence of therapeutic failure due to adverse events (AE). Statistical analysis was performed using SPSS 19.0.
Results 64 patients were included. 44 (69%) required AMS vs. 19 (31%) who did not. No statistically significant differences were observed for the variables age [56 ± 7.4 years vs. 51 ± 8.8]; sex [65% male vs. 79%]; liver fibrosis [31 (70%) F4 stage vs. 12 (63%)]; HIV-HCV co-infection [14% vs. 16%]; baseline haemoglobin [145 ± 18 mg/dl vs. 154 ± 15]; AST [74 ± 50 mU/ml vs. 78 ± 46] and ALT levels [66 ± 44 mU/ml vs. 68 ± 32]. Regarding the AMS used, 22 (34%) received at least one dose of rh-EPO, 4 (6%) of G-CSF and 37 (58%) required a ribavirin dose adjustment with a median of one dose adjustment [1–6]. The minimum ribavirin dose prescribed was 400 mg in 6 (9%) patients, followed by 600 mg [12 (19%)] 800 mg [13 (20%)] and 1000 mg [6 (9%)]. A statistically significant difference (p < 0.05) was found between the use of AMS and failure due to AE [3 (7%) vs. 7 (37%)].
Conclusions Regarding the safety profile of boceprevir, AMS such as ribavirin dose adjustments or the use of rh-EPO are effective in improving treatment outcomes in HCV-infected patients.
No conflict of interest.
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