Journal of Korean Society of Health-System Pharmacists (병원약사회지)

The Korean Society of Health-System Pharmacists (한국병원약사회)
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Efficacy and Safety of Daclatasvir and Asunaprevir Combination Therapy in Elderly Chronic Hepatitis C Patients

고령의 만성 C형 간염 환자에서 Daclatasvir와 Asunaprevir 병용 요법의 유효성 및 안전성 평가

  • Park, You Kyung (Department of Pharmacy, Seoul St. Mary's Hospital, The Catholic University of Korea) ;
  • Shin, Su Jin (Department of Pharmacy, Seoul St. Mary's Hospital, The Catholic University of Korea) ;
  • Choi, You Ock (Department of Pharmacy, Seoul St. Mary's Hospital, The Catholic University of Korea) ;
  • Choi, Hye Jung (Department of Pharmacy, St. Paul's Hospital, The Catholic University of Korea) ;
  • Kang, Jin Suk (Department of Pharmacy, Seoul St. Mary's Hospital, The Catholic University of Korea) ;
  • Hwangbo, Shin-Yi (Department of Pharmacy, Seoul St. Mary's Hospital, The Catholic University of Korea)
  • 박유경 (가톨릭대학교 서울성모병원 약제부) ;
  • 신수진 (가톨릭대학교 서울성모병원 약제부) ;
  • 최유옥 (가톨릭대학교 서울성모병원 약제부) ;
  • 최혜정 (가톨릭대학교 성바오로병원 약제팀) ;
  • 강진숙 (가톨릭대학교 서울성모병원 약제부) ;
  • 황보신이 (가톨릭대학교 서울성모병원 약제부)
  • Received : 2018.04.03
  • Accepted : 2018.09.14
  • Published : 2018.12.31
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Abstract

Background : The prevalence of chronic hepatitis C virus (HCV) tends to be higher in the elderly. Pegylated interferon and ribavirin therapy (Peg-IFN/RBV) was recommended as the first-line treatment in the past decades, but this regimen showed unsatisfactory results in terms of safety and efficacy especially in elderly patients. Recently, it was demonstrated that dual therapy with daclatasvir and asunaprevir was well tolerated and led to high sustained virological response (SVR) rates, irrespective of age. We conducted a study to evaluate the efficacy and safety of daclatasvir plus asunaprevir by involving elderly patients aged above 65 years. Methods : We retrospectively analyzed clinical data from chronic hepatitis C virus (HCV) genotype 1b patients treated with daclatasvir plus asunaprevir from September 2015 to December 2016 at Seoul St. Mary's hospital. The patients were divided into two groups as elderly patients (older than 65 years) and non-elderly patients (younger than 65 years) and compared the efficacy and safety. Results : A total of 112 patients were treated with daclatasvir plus asunaprevir for chronic hepatitis C. Among them, 101 patients completed the whole treatment, and in 88 patients the amount of HCV RNA was measured after 12 weeks of treatment. There was no significant difference in SVR at 12 weeks between both the groups (p=0.68). Typically, 91.4%(32/35) of elderly patients and 94.3%(50/53) of non-elderly patients achieved SVR12. Common adverse events included elevation in transaminase level, headache, and gastrointestinal disorders. There was no statistical difference in the symptoms between the two groups. Conclusions : The combination therapy with daclatasvir plus asunaprevir exhibited similar rates of SVR12 in HCV elderly patients without leading to further adverse events compared to non-elderly patients. Therefore, it is proposed that daclatasvir plus asunaprevir therapy could be considered as an effective and safe treatment, even in patients aged over 65 years.

Keywords

Acknowledgement

Supported by : 한국보건산업진흥원

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