Sicras-Mainar Antoni, Morillo-Verdugo Ramón
Dirección Científica. Health economics and outcomes research. Atrys Health, Barcelona.
Adicciones. 2022 Nov 29;34(4):279-284. doi: 10.20882/adicciones.1551.
Our objective was to determine potential drug interactions (DI) between pangenotypic direct-acting antivirals (pDAA) and concomitant central nervous system (CNS) medication in patients with chronic hepatitis C virus (HCV). Transversal design. Patients aged ≥ 18 years on treatment with pDAA during 2017 were included. The variables collected were comorbidity, concomitant CNS medication and potential DI. The pDAA analyzed were a) Sofosbuvir/Velpatasvir (SOF/VEL), b) Glecaprevir/Pibrentasvir (GLE/PIB) and c) Sofosbuvir/Velpatasvir/Voxilaprevir (SOF/VEL/VOX). Descriptive statistical analysis. We recruited 1,170 patients (mean age 60.1 years, 56.4% male). Mean concomitant drug use was 3.2 per patient/year. The percentages of potential / possible DI between the DAAs and the concomitant drugs on the CNS were: 2.7% contraindications, 11.3% significant and 4.2% weak. By pDAA, the percentages were: SOF/VEL (2.7%; 0.0%; 4.4%), GLE/GDP (2.7%; 26.5%; 1.6%) SOF/VEL/VOX (2.7%; 6.8%; 4.4%), respectively. Concomitant CNS medication was used in one third of HCV patients. It is important to select a pDAA with a low rate of potential DI to simplify treatment. SOF/VEL is a good alternative compared with the other pDAA studied, mainly due to the concomitant use of antipsychotics and analgesics.
我们的目标是确定慢性丙型肝炎病毒（HCV）患者中泛基因型直接抗病毒药物（pDAA）与中枢神经系统（CNS）合并用药之间的潜在药物相互作用（DI）。横断面设计。纳入2017年接受pDAA治疗的年龄≥18岁的患者。收集的变量包括合并症、CNS合并用药和潜在的药物相互作用。分析的pDAA有：a）索磷布韦/维帕他韦（SOF/VEL），b）格卡瑞韦/哌仑他韦（GLE/PIB），c）索磷布韦/维帕他韦/伏西瑞韦（SOF/VEL/VOX）。描述性统计分析。我们招募了1170名患者（平均年龄60.1岁，56.4%为男性）。每位患者每年平均合并用药3.2种。DAA与CNS合并用药之间潜在/可能的药物相互作用百分比为：禁忌2.7%，显著11.3%，微弱4.2%。按pDAA划分，百分比分别为：SOF/VEL（2.7%；0.0%；4.4%），GLE/GDP（2.7%；26.5%；1.6%），SOF/VEL/VOX（2.7%；6.8%；4.4%）。三分之一的HCV患者使用了CNS合并用药。选择潜在药物相互作用发生率低的pDAA以简化治疗很重要。与其他研究的pDAA相比，SOF/VEL是一个很好的选择，主要是因为其与抗精神病药和镇痛药的合并使用情况。
