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Review of Clinically Relevant Drug Interactions with Next Generation Hepatitis C Direct-acting Antiviral Agents

Journal of Clinical and Translational Hepatology 2020年第3期8卷 322-335页

作者： Jenny Hong robert C.Wright Nilu Partovi Eric M.Yoshida Trana Hussaini Pharmaceutical Sciences Vancouver General HospitalVancouverBCCanada Faculty of Pharmaceutical Sciences University of British ColumbiaVancouverBCCanada Liver Transplant Program Vancouver General HospitalVancouverBCCanada Division of Gastroenterology Faculty of MedicineUniversity of British ColumbiaVancouverBCCanada

In this review,we examine the pharmacokinetics and clinically relevant drug interactions of the newer generation direct-acting antivirals(DAAs)for the treatment of chronic hepatitis C,specifically sofosbuvir/velpatasvir(Epclusa®),sofosbuvir/velpatasvir/voxilaprevir(Vosevi®),glecaprevir/pibrentasvir(Maviret®),and elbasvir/grazoprevir(Zepatier®).We searched MEDLINE(1948-January 2020),Embase(1964-January 2020),Google,and GoogleScholar using the terms pharmacokinetics,drug interaction,drug metabolism,sofosbuvir,velpatasvir,Epclusa,voxilaprevir,Vosevi,glecaprevir,pibrentasvir,Maviret,elbasvir,grazoprevir,and Zepatier,from inception to January 13,*** search was limited to randomized controlled trials,in vitro studies,prospective and retrospective human studies,drug monographs,abstracts,and conference *** relevant published literature on pharmacokinetic and pharmacodynamic interactions involving DAAs were reviewed and the data *** clinically relevant drug-drug interactions(DDIs)were identified with the newer generation DAAs and commonly prescribed ***3/4A protease inhibitors are more likely to be involved in DDIs,followed by NS5A inhibitors and NS5B polymerase *** majority of clinically relevant DDIs are predictable,according to known pharmacokinetic,pharmacodynamics,and physicochemical properties of DAAs;however,in select cases,unpredictable DDIs do *** expected,many drug interactions exist between newer generation DAAs and commonly prescribed *** the majority of clinically relevant interactions are predictable,many require therapeutic dose adjustment or careful selection of non-interacting *** select cases,severe and unpredictable drug interactions can *** should consult hepatitis C virus pharmacotherapy experts and tertiary drug interaction resources when initiating DAA therapy in patients taking other medications.

关键词： Hepatitis C Drug interactions Pharmacokinetics Direct-acting antiviral agents

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