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PS-029 Impact of haematological adverse events of triple therapy in patients with hepatitis C
  1. L Recuero Galve,
  2. A Mulet Alberola,
  3. J Sánchez Gundín,
  4. M Llorente Serrano,
  5. M Mejía Recuero,
  6. D Barreda Hernández
  1. Hospital Virgen de La Luz, Pharmacy Hospital, Cuenca, Spain

Abstract

Background Protease inhibitor treatment (PIT) represents an important advance for patients with hepatitis C. However, PIT may produce haematological adverse events (HAE).

Purpose To analyse the impact of HAE in hepatitis C patients who have been treated with PIT.

Material and methods Retrospective observational study (December 2012–August 2014) of patients with PIT who suffered HAE requiring supportive treatment in a general hospital.

Data collected:

  • Medical record review: weight, treatment (drug, dose, length of treatment) and HAE.

  • Outpatients database: cost of real (including supportive treatment) and theoretical (without HAE) treatment per patient.

Results 12 patients (7 with telaprevir, 5 with boceprevir) began PIT. 6 (3 male and 3 female) median age 53.3 ± 3.2 years suffered from HAE, requiring supportive treatment (4 patients with weight ≥75 kg).

Telaprevir patients:

  • 2 patients presented neutropenia between 8th and 12th week. The pegylated-interferon-?2a dose was reduced and they were treated with filgrastim 48 MIU until 36th and 43th week, respectively, when they stopped their treatment due to other adverse events (AE).

  • 2 patients (1 co-infected with HIV) suffered anaemia from 6th and 8th week. Their ribavirin dose was reduced. One patient was given epoetin-alfa 40,000 IU until 7th week when he stopped treatment due to other AEs. The HIV-co-infected patient began darbepoetin-alfa 50–100 mcg (treatment finished after 48 weeks). Both needed blood transfusions (this cost was not evaluated).

Boceprevir patients:

  • 1 patient stopped PIT at 7th week for severe neutropenia, having reduced pegylated-interferon-a2b dose previously. Afterwards, one dose of filgrastim 30 MIU was necessary.

  • 1 patient reduced pegylated-interferon-?2a dose for severe thrombocytopenia in the 8th week. Later, he was given eltrombopag 25 mg until the end of PIT (48 weeks).

The real cost was €179,439.9 and theoretical cost €169,674.9.

Conclusion 50% of patients with treatment with IP needed supportive treatment to manage HAE. The real cost was higher than the theoretical cost (6.8%), but they could continue their PIT, although 4 patients had to finish it later because of other side effects.

References and/or acknowledgements No conflict of interest.

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