Background In recent years the treatment of hepatitis C has seen a great evolution, from combination therapy in 1998 to the appearance of the new direct antiviral agents today. This new therapeutic stage aims to achieve higher response rates, lower complexity and better tolerability.
Purpose To analyse the viral response at week 12 and tolerability of direct antiviral agents in clinical practice for patients with hepatitis C.
Material and methods Prospective observational study conducted at the outpatient pharmaceutical care unit. All hepatitis C patients who had started new free interferon treatment from January to September of 2015 were included. Analytical and clinical data obtained through the pharmacotherapeutic history, patient interview at every dispensation and from the electronic laboratory register were evaluated.
Results 123 patients (71.3% men; median 54.5 years) were included: 10.6% had been treated with daclatasvir/sofosbuvir, 11.4% with ombitasvir/paritaprevir/ritonavir ± dasabuvir, 30.1% with ledipasvir/sofosbuvir and 47.9% with simeprevir/sofosbuvir. All treatments could be combinated or not with ribavirin. Type of patient: 58.6% naïve, 22.1% non-responders, 6.7% partial responders and 12.5% pretreated not classifiable in the other categories. Degree of fibrosis: 2.5% F1, 14.6% F2, 17.1% F3 and 65.8% F4. Viral genotype: 37.3% genotype 1a, 44.1% genotype 1b, 1.7% genotype 2, 6.7% genotype 3 and 11% genotype 4. 20.3% were coinfected. At week 12, 82.9% of patients had undetectable viral load, 3.25% detectable viral load, 11.4% unknown viral load and 2.4% exited before reaching week 12. 30% of patients had skin reactions, 9.8% gastrointestinal reactions, 43% asthenia, 8.9% anaemia (all in combination with ribavirin), 7% insomnia and 43.9% another one. One patient required hospitalisation due to side effects (anaemia in the daclatasvir/sofosbuvir /ribavirin group). No patient discontinued treatment due to adverse effects.
Conclusion New direct antiviral agents showed a high rate of disappearance by 12 weeks and were well tolerated.
References and/or Acknowledgements
Jimenez Galan R, et al. Farm Hosp 2014;30:231-47
References and/or AcknowledgementsNo conflict of interest.
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