Academic Journal
Comparison of the effect of direct-acting antiviral with and without ribavirin on cyclosporine and tacrolimus clearance values: results from the ANRS CO23 CUPILT cohort
| العنوان: | Comparison of the effect of direct-acting antiviral with and without ribavirin on cyclosporine and tacrolimus clearance values: results from the ANRS CO23 CUPILT cohort |
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| المؤلفون: | Barrail-Tran, Aurélie, Goldwirt, Lauriane, Gelé, Thibaut, Laforest, Claire, Lavenu, Audrey, Danjou, Hélène, Radenne, Sylvie, Leroy, Vincent, Houssel-Debry, Pauline, Duvoux, Christophe, Kamar, Nassim, De Ledinghen, Victor, Canva, Valérie, Conti, Filomena, Durand, François, D’Alteroche, Louis, Botta-Fridlund, Danielle, Moreno, Christophe, Cagnot, Carole, Samuel, Didier, Fougerou-Leurent, Claire, Pageaux, Georges-Philippe, Duclos-Vallée, Jean-Charles, Taburet, Anne Marie, Coilly, Audrey |
| المصدر: | European Journal of Clinical Pharmacology |
| سنة النشر: | 2019 |
| المجموعة: | DI-fusion : dépôt institutionnel de l'Université libre de Bruxelles (ULB) |
| مصطلحات موضوعية: | Pharmacologie, Anaemia, Liver fibrosis, Ribavirin, Tacrolimus |
| الوصف: | Purpose: Direct-acting antiviral agents have demonstrated their efficacy in treating HCV recurrence after liver transplantation and particularly the sofosbuvir/daclatasvir combination. Pharmacokinetic data on both calcineurin inhibitors and direct-acting antiviral exposure in liver transplant recipients remain sparse. Methods: Patients were enrolled from the ANRS CO23 CUPILT cohort. All patients treated with sofosbuvir/daclatasvir with or without ribavirin were included in this study when blood samples were available to estimate the clearance of immunosuppressive therapy before direct-acting antiviral initiation and during follow-up. Apparent tacrolimus and cyclosporine clearances were estimated from trough concentrations measured using validated quality control assays. Results: Sixty-seven mainly male patients (79%) were included, with a mean age of 57 years and mean MELD score of 8.2; 50 were on tacrolimus, 17 on cyclosporine. Ribavirin was combined with sofosbuvir/daclatasvir in 52% of patients. Cyclosporine clearance remained unchanged as well as tacrolimus clearance under the ribavirin-free regimen. Tacrolimus clearance increased 4 weeks after direct-acting antivirals and ribavirin initiation versus baseline (geometric mean ratio 1.81; 90% CI 1.30–2.52). Patients under ribavirin had a significantly higher fibrosis stage (> 2) (p = 0.02) and lower haemoglobin during direct-acting antiviral treatment (p = 0.02) which impacted tacrolimus measurements. Direct-acting antiviral exposure was within the expected range. Conclusion: Our study demonstrated that liver transplant patients with a recurrence of hepatitis C who are initiating ribavirin combined with a sofosbuvir-daclatasvir direct-acting antiviral regimen may be at risk of lower tacrolimus concentrations because of probable ribavirin-induced anaemia and higher fibrosis score, although there are no effects on cyclosporine levels. Trial registration: NCT 01944527. ; SCOPUS: ar.j ; info:eu-repo/semantics/published |
| نوع الوثيقة: | article in journal/newspaper |
| وصف الملف: | 1 full-text file(s): application/pdf |
| اللغة: | English |
| Relation: | uri/info:doi/10.1007/s00228-019-02725-x; uri/info:scp/85070216835; https://dipot.ulb.ac.be/dspace/bitstream/2013/292459/3/BarrailTranetal2019EurJClinPharmacol.pdf; http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/292459 |
| الاتاحة: | http://hdl.handle.net/2013/ULB-DIPOT:oai:dipot.ulb.ac.be:2013/292459 https://dipot.ulb.ac.be/dspace/bitstream/2013/292459/3/BarrailTranetal2019EurJClinPharmacol.pdf |
| رقم الانضمام: | edsbas.72DAE5F6 |
| قاعدة البيانات: | BASE |
| الوصف غير متاح. |