A Cross-Sectional Study Comparing the Frequency of Drug Interactions After Adding Simeprevir- or Sofosbuvir-Containing Therapy to Medication Profiles of Hepatitis C Monoinfected Patients

Abstract

IntroductionThis study compares the expected occurrence of contraindicated drug–drug interactions (XDDIs) when simeprevir (SIM)- or sofosbuvir (SOF)-containing therapy is added to medication profiles of patients with hepatitis C (HCV) monoinfection to quantify, in relative terms, the population-based risk of XDDIs. Second, this study identified the predictors of XDDIs when HCV therapies are added to medication profiles.MethodsA cross-sectional study was performed among Veterans’ Affairs patients. Inclusion criteria were: (1) age ≥18 years, (2) HCV infection, and (3) availability of a medication list. Patients with human immunodeficiency virus were excluded. Demographics, comorbidities, year of HCV diagnosis, and most recent medication list were collected from medical records. The primary outcome was the presence of XDDIs involving HCV therapy and the medications in the patient’s home medication list after the addition of either SIM- or SOF-containing regimens. To define XDDIs, Lexi-Interact drug interaction software was used.Results4,251 patients were included. The prevalence of XDDIs involving SIM- or SOF-containing therapy were 12.6% and 4.7% (p < 0.001), respectively. In multivariable analyses examining the predictors of XDDIs involving SIM-containing therapy, the only medication-related predictor was use of ≥6 home medications (odds ratio OR 4.58, 95% confidence interval CI 3.54–5.20, p < 0.001). Similarly, use of ≥6 home medications was also the only variable associated with an increased probability of XDDI involving SOF-containing therapy (OR 3.83, 95% CI 2.57–5.70, p < 0.001).ConclusionsSofosbuvir-containing therapy had a lower frequency of XDDIs than SIM-containing therapy. Polypharmacy with various classes of home medications predicted XDDIs involving SIM- or SOF-containing therapy.Electronic supplementary materialThe online version of this article (doi:10.1007/s40121-015-0058-x) contains supplementary material, which is available to authorized users.

Comorbidities and medications of patients with chronic hepatitis C under specialist care in the UK

“…The results of our study concur with the high rates of comorbidities and use of medications with DDI potential to DAAs reported among patients with CHC in studies conducted in predominantly specialist settings in the USA 18,19 and Germany. 20 Our study complements a recent analysis of patients with CHC seen in UK primary care.…”

Drug–Drug Interactions Between Direct-Acting Antivirals and Psychoactive Medications

“…In that study, 16 % of the HCV-infected patients were on antidepressants and 10 % were on antipsychotics ( n  = 3716) [6]. This corresponds with data from a Dutch nationwide survey in which benzodiazepines, drugs used for treating opioid dependence, and selective serotonin reuptake inhibitors (SSRIs) were among the drugs most frequently used by chronic HCV-infected patients [7].…”

Drug-drug interactions in patients with malaria: a multicenter retrospective study

“…Whereas, it is lower in comparison to that reported among patients with liver cirrhosis (21.4%) [11], hepatitis C (30-44%) [19], and stroke (61%) [16]. Similarly, the prevalence of contraindicated-pDDIs in patients with malaria is also lower (14.3%) in comparison to the prevalence reported among patients with hepatitis C (16.7%) [25]. This contradiction may be due to variable study population, drug prescribing patterns, study design, considering pDDIs types, and drug interaction screening software.…”