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Mangia A, Scaglione F, Toniutto P, Pirisi M, Coppola N, Di Perri G, Alvarez Nieto G, Calabrese S, Hernandez C, Perrone V, Degli Esposti L, Fagiuoli S. Drug-Drug Interactions in Italian Patients with Chronic Hepatitis C Treated with Pangenotypic Direct Acting Agents: Insights from a Real-World Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7144. [PMID: 34281080 PMCID: PMC8296917 DOI: 10.3390/ijerph18137144] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/25/2021] [Accepted: 06/25/2021] [Indexed: 12/22/2022]
Abstract
This Italian observational real-world study aims to assess in chronic hepatitis C virus (HCV) patients treated with pangenotypic direct acting agents (pDAAs) glecaprevir/pibrentasvir (GLE/PIB) or sofosbuvir/velpatasvir (SOF/VEL) the potential drug-drug interactions (DDIs) with concomitant medications prescribed, with a focus on cardiovascular and system nervous (CNS) co-medications. Data were collected from administrative databases covering 6.9 million health-assisted individuals. All patients prescribed SOF/VEL or GLE/PIB between 11/2017 and 12/2018 were included. Patients were analyzed while on DAA. DDIs were identified according to the Liverpool University tool. Overall, 3181 HCV patients were included: 1619 in the GLE/PIB cohort and 1562 in the SOF/VEL cohort. SOF/VEL patients were generally older than GLE/PIB ones (mean age 58.4 vs. 53.1, p < 0.001) and had more cardiovascular and CNS comorbidities (58% vs. 42%, p < 0.001 and 33% vs. 28%, p = 0.002, respectively). Contraindications due to DDIs in the GLE/PIB cohort affected 9.3% and 3.2% of patients before and on DAA, respectively, while the percentages in the SOF/VEL cohort were 3.2% before and 0.4% after pDAAs initiation. Among GLE/PIB patients, 2.7% had cardiovascular drugs (all statins) contraindicated while on DAA. The potential DDIs between cardiovascular drugs and SOF/VEL were mainly with statins (5%). SOF/VEL was prescribed in patients with older age and with more cardiovascular and CNS comorbidities. Despite this, a proportion of contraindicated drugs lower than that of GLE/PIB was registered.
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Affiliation(s)
- Alessandra Mangia
- Liver Unit, Fondazione “Casa Sollievo Della Sofferenza” IRCCS, 71013 San Giovanni Rotondo, Italy;
| | - Francesco Scaglione
- Department of Oncology and Onco-Hematology, University of Milan, 20122 Milan, Italy;
| | - Pierluigi Toniutto
- Hepatology and Liver Transplantation Unit, Azienda Ospedaliero Universitaria, 33100 Udine, Italy;
| | - Mario Pirisi
- Department of Translational Medicine (DiMeT), Università del Piemonte Orientale, 28100 Novara, Italy;
| | - Nicola Coppola
- Department of Mental Health and Public Medicine–Infectious Diseases Unit, University of Campania Luigi Vanvitelli, 81100 Caserta, Italy;
| | - Giovanni Di Perri
- Department of Medical Sciences, University of Turin, 10124 Turin, Italy;
| | - Gema Alvarez Nieto
- Gilead Sciences, Medical Affairs Italy, 202124 Milan, Italy; (G.A.N.); (S.C.)
| | - Stefano Calabrese
- Gilead Sciences, Medical Affairs Italy, 202124 Milan, Italy; (G.A.N.); (S.C.)
| | - Candido Hernandez
- Gilead Sciences, Global Medical Affairs, Stockley Park, London UB11 1BD, UK;
| | - Valentina Perrone
- CliCon S.r.l. Health, Economics & Outcomes Research, 40137 Bologna, Italy;
| | - Luca Degli Esposti
- CliCon S.r.l. Health, Economics & Outcomes Research, 40137 Bologna, Italy;
| | - Stefano Fagiuoli
- Gastroenterology and Transplant Hepatology, Papa Giovanni XXIII Hospital, 24127 Bergamo, Italy;
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