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Ribavirin dose management in HCV patients receiving ombitasvir/paritaprevir/ritonavir and dasabuvir with ribavirin

(2018) LIVER INTERNATIONAL. 38(9). p.1571-1575
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Abstract
Background & Aims: Some individuals with hepatitis C virus infection treated with direct-acting antivirals require ribavirin to maximize sustained virological response rates. We describe the clinical management of ribavirin dosing in hepatitis C virus-infected patients receiving ombitasvir/paritaprevir/ritonavir and dasabuvir with ribavirin. Methods: We performed a post hoc analysis of patients receiving ombitasvir/paritaprevir/ritonavir and dasabuvir with ribavirin for 12 or 24 weeks in six phase 3 trials. Multivariate stepwise logistic regression models assessed predictors associated with ribavirin dose adjustments and with developing anaemia. Results: Of 1548 patients, 100 (6.5%) modified ribavirin dose due to haemoglobin declines, of which 99% achieved sustained virological response at 12 weeks post-treatment. Median time to first ribavirin dose reduction was 37 days. Low baseline haemoglobin was significantly associated with an increased risk of requiring ribavirin dose modification (odds ratio: 0.618 [0.518, 0.738]; P < .001) and developing anaemia (odds ratio: 0.379 [0.243, 0.593]; P < .001). Conclusions: Ribavirin dose reductions were infrequent, occurred early in treatment, and did not impact sustained virological response at 12 weeks post-treatment. Patients with low baseline haemoglobin should be monitored for on-treatment anaemia.
Keywords
CHRONIC HEPATITIS-C, TREATMENT-EXPERIENCED PATIENTS, VIRUS-INFECTION, PLUS RIBAVIRIN, ABT-450/R-OMBITASVIR, THERAPY, ANEMIA, CIRRHOSIS, COMBINATION, SOFOSBUVIR, anaemia, dasabuvir, ombitasvir, paritaprevir, ribavirin

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Chicago
Feld, Jordan J, David E Bernstein, Ziad Younes, Hans Van Vlierberghe, Lois Larsen, Fernando Tatsch, and Peter Ferenci. 2018. “Ribavirin Dose Management in HCV Patients Receiving Ombitasvir/paritaprevir/ritonavir and Dasabuvir with Ribavirin.” Liver International 38 (9): 1571–1575.
APA
Feld, J. J., Bernstein, D. E., Younes, Z., Van Vlierberghe, H., Larsen, L., Tatsch, F., & Ferenci, P. (2018). Ribavirin dose management in HCV patients receiving ombitasvir/paritaprevir/ritonavir and dasabuvir with ribavirin. LIVER INTERNATIONAL, 38(9), 1571–1575.
Vancouver
1.
Feld JJ, Bernstein DE, Younes Z, Van Vlierberghe H, Larsen L, Tatsch F, et al. Ribavirin dose management in HCV patients receiving ombitasvir/paritaprevir/ritonavir and dasabuvir with ribavirin. LIVER INTERNATIONAL. 2018;38(9):1571–5.
MLA
Feld, Jordan J, David E Bernstein, Ziad Younes, et al. “Ribavirin Dose Management in HCV Patients Receiving Ombitasvir/paritaprevir/ritonavir and Dasabuvir with Ribavirin.” LIVER INTERNATIONAL 38.9 (2018): 1571–1575. Print.
@article{8572866,
  abstract     = {Background \& Aims: Some individuals with hepatitis C virus infection treated with direct-acting antivirals require ribavirin to maximize sustained virological response rates. We describe the clinical management of ribavirin dosing in hepatitis C virus-infected patients receiving ombitasvir/paritaprevir/ritonavir and dasabuvir with ribavirin. 
Methods: We performed a post hoc analysis of patients receiving ombitasvir/paritaprevir/ritonavir and dasabuvir with ribavirin for 12 or 24 weeks in six phase 3 trials. Multivariate stepwise logistic regression models assessed predictors associated with ribavirin dose adjustments and with developing anaemia. 
Results: Of 1548 patients, 100 (6.5\%) modified ribavirin dose due to haemoglobin declines, of which 99\% achieved sustained virological response at 12 weeks post-treatment. Median time to first ribavirin dose reduction was 37 days. Low baseline haemoglobin was significantly associated with an increased risk of requiring ribavirin dose modification (odds ratio: 0.618 [0.518, 0.738]; P {\textlangle} .001) and developing anaemia (odds ratio: 0.379 [0.243, 0.593]; P {\textlangle} .001). 
Conclusions: Ribavirin dose reductions were infrequent, occurred early in treatment, and did not impact sustained virological response at 12 weeks post-treatment. Patients with low baseline haemoglobin should be monitored for on-treatment anaemia.},
  author       = {Feld, Jordan J and Bernstein, David E and Younes, Ziad and Van Vlierberghe, Hans and Larsen, Lois and Tatsch, Fernando and Ferenci, Peter},
  issn         = {1478-3223},
  journal      = {LIVER INTERNATIONAL},
  language     = {eng},
  number       = {9},
  pages        = {1571--1575},
  title        = {Ribavirin dose management in HCV patients receiving ombitasvir/paritaprevir/ritonavir and dasabuvir with ribavirin},
  url          = {http://dx.doi.org/10.1111/liv.13708},
  volume       = {38},
  year         = {2018},
}

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