Drug-drug interaction of direct-acting antivirals in treatment of chronic hepatitis C
-
摘要:
随着直接抗病毒药物(DAA)在治疗丙型肝炎中的成功应用,药物之间相互作用(DDI)的临床管理成为了丙型肝炎治疗领域值得关注的热点之一。大部分DAA通过肝脏和(或)肠道的细胞色素P450酶系或转运蛋白,与合并用药发生DDI。目前,欧洲肝病学会发布了慢性丙型肝炎DAA相互作用的推荐意见,涵盖抗HIV逆转录病毒药物、降脂药/心血管药物、免疫抑制剂和中枢神经系统成瘾药物等。临床医师在制订DAA治疗方案时,应该对DDI的风险进行严密评估和监测,以最大程度降低或避免抗病毒治疗在内的相关治疗失败或不良反应发生。
Abstract:With the successful application of direct-acting antivirals (DAAs) in the treatment of hepatitis C, clinical management of drug-drug interaction (DDI) has become a hot topic in this field.Most DAAs develop DDI with other drugs administered at the same time via cytochrome P450 or transporters in the liver and/or the intestine.At present, European Association for the Study of the Liver has published the recommendations on DDI of DAAs in the treatment of chronic hepatitis C, which covers HIV antiretrovirals, lipid-lowering drugs, cardiovascular drugs, immunosuppressants, and addictive drugs for the central nervous system.When developing the regimens for DAA treatment, clinicians should closely assess and monitor the risk of DDI, in order to reduce or avoid treatment failure or adverse reactions during antiviral therapy.
-
Key words:
- hepatitis C, chronic /
- antiviral agents /
- drug interactions
-
[1]European Association for the Study of the Liver.EASL recommendations on treatment of hepatitis C 2016[J].J Hepatol, 2017, 66 (1) :153-194. [2]WHO Guidelines Approved by the Guidelines Review Committee.Guidelines for the screening care and treatment of persons with chronic hepatitis C infection:updated version[J].Geneva:World Health Organization, 2016. [3]KISER JJ, BURTON JR Jr, EVERSON GT.Drug-drug interactions during antiviral therapy for chronic hepatitis C[J].Nat Rev Gastroenterol Hepatol, 2013, 10 (10) :596-606. [4]TALAVERA PONS S, BOYER A, LAMBLIN G, et al.Managing drug-drug interactions with new direct-acting antiviral agents in chronic hepatitis C[J].Br J Clin Pharmacol, 2017, 83 (2) :269-293. [5]GAY C, TOULET D, Le CORRE P.Pharmacokinetic drug-drug interactions of tyrosine kinase inhibitors:a focus on cytochrome P450, transporters, and acid suppression therapy[J].Hematol Oncol, 2017, 35 (3) :259-280. [6]SORIANO V, LABARGA P, BARREIRO P, et al.Drug interactions with new hepatitis C oral drugs[J].Expert Opin Drug Metab Toxicol, 2015, 11 (3) :333-341. [7]SEGNA D, DUFOUR JF.Other extrahepatic manifestations of hepatitis C virus infection (pulmonary, idiopathic thrombocytopenic purpura, nondiabetes endocrine disorders) [J].Clin Liver Dis, 2017, 21 (3) :607-629. [8]MENON RM, BADRI PS, WANG T, et al.Drug-drug interaction profile of the all-oral anti-hepatitis C virus regimen of paritaprevir/ritonavir, ombitasvir, and dasabuvir[J].J Hepatol, 2015, 63 (1) :20-29. [9]MOHD HANAFIAH K, GROEGER J, FLAXMAN AD, et al.Global epidemiology of hepatitis C virus infection:new estimates of age-specific antibody to HCV seroprevalence[J].Hepatology, 2013, 57 (4) :1333-1342. [10]FELD JJ, MORENO C, TRINH R, et al.Sustained virologic response of 100%in HCV genotype 1b patients with cirrhosis receiving ombitasvir/paritaprevir/r and dasabuvir for 12 weeks[J].J Hepatol, 2016, 64 (2) :301-307. [11]MARCUS EL, TUR-KASPA R.Chronic hepatitis C virus infection in older adults[J].Clin Infect Dis, 2005, 41 (11) :1606-1612. [12]BANERJEE D, REDDY KR.Review article:safety and tolerability of direct-acting anti-viral agents in the new era of hepatitis C therapy[J].Aliment Pharmacol Ther, 2016, 43 (6) :674-696. [13]ESLAM M, KHATTAB MA, HARRISON SA.Insulin resistance and hepatitis C:an evolving story[J].Gut, 2011, 60 (8) :1139-1151. [14]WYLES DL, RUANE PJ, SULKOWSKI MS, et al.Daclatasvir plus sofosbuvir for HCV in patients coinfected with HIV-1[J].N Engl J Med, 2015, 373 (8) :714-725. [15] Chinese Society of Hepatology and Chinese Society of Infectious Diseases, Chinese Medical Association.The guideline of prevention and treatment for hepatitis C:a 2015 update[J].J Clin Hepatol, 2015, 31 (12) :1961-1979. (in Chinese) 中华医学会肝病学分会, 中华医学会感染病学分会.丙型肝炎防治指南 (2015年更新版) [J].临床肝胆病杂志, 2015, 31 (12) :1961-1979.
计量
- 文章访问数: 2424
- HTML全文浏览量: 26
- PDF下载量: 499
- 被引次数: 0