The quetiapine question: management strategies for drug-drug interactions with antipsychotics and direct acting antivirals; a multicentre review

Davidson, Katherine; Boyle, Alison; Barclay, Stephen; Boxall, Elspeth; Fleming, Cecilia; Gossman, Peter; McAvennie, Janice; Reilly, Elaine; Sheridan, Elaine; Sommerville, Andrew; Marra, Fiona

doi:10.1016/s0168-8278(20)31196-x

Cited by 2 publications

(1 citation statement)

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“…However, current direct-acting antivirals (DAAs) are clinically effective (≥95% cure rates), with favourable safety and tolerability profiles, low chance of late relapse following sustained virological response (SVR) [4,12], and no negative effects on mental health [11,[13][14][15]. Psychoactive drugs, including antipsychotics such as quetiapine, are commonly prescribed in patients with mental health disorders [16][17][18]. Therefore, drug-drug interactions (DDIs) are an important consideration in the management of HCV in people with mental health disorders.…”

Section: Introductionmentioning

confidence: 99%

Global Real-World Evidence of Sofosbuvir/Velpatasvir as a Highly Effective Treatment and Elimination Tool in People with Hepatitis C Infection Experiencing Mental Health Disorders

Wedemeyer

Marco

García–Retortillo

et al. 2022

Viruses

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Hepatitis C virus (HCV) is prevalent in people with mental health disorders, a priority population to diagnose and cure in order to achieve HCV elimination. This integrated analysis pooled data from 20 cohorts in seven countries to evaluate the real-world effectiveness of the pangenotypic direct-acting antiviral (DAA) sofosbuvir/velpatasvir (SOF/VEL) in people with mental health disorders. HCV-infected patients diagnosed with mental health disorders who were treated with SOF/VEL for 12 weeks without ribavirin as part of routine clinical practice were included. The primary outcome was sustained virological response (SVR) in the effectiveness population (EP), defined as patients with an available SVR assessment. Secondary outcomes were reasons for not achieving SVR, characteristics of patients with non-virological failures, adherence, and time from HCV RNA diagnosis to SOF/VEL treatment initiation. A total of 1209 patients were included; 142 did not achieve an SVR for non-virological reasons (n = 112; 83 lost to follow-up, 20 early treatment discontinuations) or unknown reasons (n = 30). Of the 1067 patients in the EP, 97.4% achieved SVR. SVR rates in the EP were ≥95% when stratified by type of mental health disorder and other complicating baseline characteristics, including active injection drug use and antipsychotic drug use. Of 461 patients with data available in the EP, only 2% had an adherence level < 90% and 1% had an adherence level < 80%; all achieved SVR. Patients with mental health disorders can be cured of HCV using a well-tolerated, pangenotypic, protease inhibitor-free SOF/VEL regimen. This DAA allows the implementation of a simple treatment algorithm, with minimal monitoring requirements and fewer interactions with central nervous system drugs compared with protease-inhibitor DAA regimens.

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Section: Introductionmentioning

confidence: 99%

Global Real-World Evidence of Sofosbuvir/Velpatasvir as a Highly Effective Treatment and Elimination Tool in People with Hepatitis C Infection Experiencing Mental Health Disorders

Wedemeyer

Marco

García–Retortillo

et al. 2022

Viruses

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Resource utilization associated with the management of potential interactions between direct-acting antivirals for chronic hepatitis C treatment and cardiovascular and central nervous system drugs

Molina,

Torrens,

Ampuero

et al. 2022

EDS

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Objective: Patients with chronic Hepatitis C Virus Infection (HCV) present high rates of comorbidity and polypharmacy. We aimed to assess the additional actions and resource utilization required for the management of potential drug-drug interactions (pDDIs) in HCV patients showing cardiovascular (CVS) and central nervous system (CNS) comorbidities, treated with sofosbuvir/velpatasvir (SOF/VEL) compared to glecaprevir/pibrentasvir (GLE/PIB) in routine clinical practice in Spain. Methods: The most prevalent CVS and CNS drugs in HCV patients were identified from real-world published data. The pDDIs between SOF/VEL, GLE/PIB and comedications, and their management recommendations were identified on the University of Liverpool Hepatitis Drug Interaction Group website. An expert panel defined real-world management of pDDIs, and a consensus was reached on actions required on the concomitant drug and resource utilization. Results: Additional actions are required in 89% of the CVS drugs when co-administered with GLE/PIB, while 39% were required with SOF/VEL (dose adjustment: 39% vs 17%; drug suspension: 28% vs 11%; drug substitution: 22% vs 11%; drug restart after DAA treatment: 33% vs 22%); additional visits and/or tests are needed in 50% and 22%, respectively. Regarding CNS drugs, 71% required additional actions when co-administered with GLE/PIB, while 14% require them with SOF/VEL (dose adjustment: 57% vs 0%; drug substitution: 14% vs 14%); additional visits and/or tests are needed in 71% and 14%, respectively. Conclusion: In routine clinical practice, fewer actions and less resource utilization are needed to manage pDDIs with SOF/VEL than with GLE/PIB, when treating HCV patients with CVS and CNS comorbidities. Keywords: chronic hepatitis C; drug-drug interactions; pangenotypic direct acting antivirals; resource utilization; comorbidity.

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The quetiapine question: management strategies for drug-drug interactions with antipsychotics and direct acting antivirals; a multicentre review

Cited by 2 publications

References 0 publications

Global Real-World Evidence of Sofosbuvir/Velpatasvir as a Highly Effective Treatment and Elimination Tool in People with Hepatitis C Infection Experiencing Mental Health Disorders

Global Real-World Evidence of Sofosbuvir/Velpatasvir as a Highly Effective Treatment and Elimination Tool in People with Hepatitis C Infection Experiencing Mental Health Disorders

Resource utilization associated with the management of potential interactions between direct-acting antivirals for chronic hepatitis C treatment and cardiovascular and central nervous system drugs

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