Glecaprevir and Pibrentasvir in Patients with HCV and Severe Renal Impairment

Gane, Edward; Lawitz, Eric; Pugatch, David; Papatheodoridis, George V.; Bräu, Norbert; Brown, Ashley; Pol, Stanislas; Leroy, Vincent; Persico, Marcello; Moreno, Christophe; Colombo, Massimo; Yoshida, Eric M.; Nelson, David R.; Collins, Christine A.; Yang, Lei; Kosloski, Matthew P.; Mensa, Federico

doi:10.1056/nejmoa1704053

Cited by 360 publications

(365 citation statements)

References 24 publications

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“…Therefore, sofosbuvir-free treatment options should be preferred if possible. Since the introduction of the pangenotypic combination of glecaprevir/pibrentasvir, a highly effective treatment of GT 2 and 3 is available, and safety and efficacy for patients with renal impairment and hemodialysis have been shown successfully [28]. Alternatively, grazoprevir/elbasvir can be safely administered in patients with GT 1 or 4 infection and severe renal dysfunction [29].…”

Section: Special Groups Of Patientsmentioning

confidence: 99%

Treatment of Chronic Hepatitis C: Efficacy, Side Effects and Complications

et al. 2019

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Background: Chronic hepatitis C virus (HCV) infection can lead to liver cirrhosis and its complications. Viral eradication is essential to prevent disease progression and reduces liver-related mortality and morbidity. Since the availability of direct-acting antivirals (DAA), HCV treatment has changed significantly. Current treatment strategies for different groups of patients as well as potential risks and caveats will be discussed in this review. Summary: Interferon-free (IFN-free) treatment not only shortens treatment duration, but also achieves high rates of viral clearance and is overall well tolerated. Genotype-restricted but also pangenotypic combinations are available. Usually two DAA of different drug classes are combined. For the majority of the patients, treatment duration ranges from 8 to 12 weeks. Liver and kidney function as well as prior treatment experience and potential drug-drug interactions influence substance choices and treatment duration. However, modern IFN-free treatment is not only safer, but also overall far more simplified and effective. Global HCV eradication might be an ambitious but not completely unrealistic goal to pursue. Key Messages: IFN-free antiviral treatment is safe and well tolerated. Patients can be treated almost independently of liver function or concomitant disease. Viral eradication is associated with reduced morbidity and mortality and better quality of life.

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Section: Special Groups Of Patientsmentioning

confidence: 99%

Treatment of Chronic Hepatitis C: Efficacy, Side Effects and Complications

et al. 2019

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“…In a multicenter phase 3 study, patients with HCV were treated with glecaprevir and pibrentasvir [7]; 88% of the patients were on hemodialysis and 58% were treatment naive, with no previous hepatitis C therapy. The posttreatment results were again in the 95–100% range, with impressively 37% of the patients already at week 1 having no HCV detectable in the blood.…”

Section: Screening and Treating Hepatitis C In Chronic Kidney Diseasementioning

confidence: 99%

Nephro Update Europe 2018

Kesel¹

2019

Kidney Dis

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“…In a nonrandomized, observational study, the pan-genotypic combination of glecaprevir and pibrentasvir was evaluated in patients with advanced CKD/ESKD (EXPEDITION 4). An SVR12 of 98% was achieved with minimal adverse events (8). The HCV-TARGET (Hepatitis C therapeutic registry and research network) is a realworld outcome study of sofosbuvir-based regimens (5).…”

Section: Treatment Options For Hcv Infection In Patients With Eskdmentioning

confidence: 99%

“…The direct acting antiviral (DAA) agents deliver sustained virologic response rates (undetectable viral load 12 weeks after completion of treatment; SVR12) that routinely exceed 90% after an 8-or 12-week course of therapy. After publication of the pivotal studies completed in the general population (1,4), trials that focused on patients with CKD and ESKD infected with HCV reproduced these excellent results with low adverse event profiles (5)(6)(7)(8). With the availability of safe and effective treatment options for patients with kidney disease, it is important that nephrologists be familiar with the therapeutic possibilities best suited for those with ESKD infected with HCV.…”

Section: Introductionmentioning

confidence: 99%