Uso concomitante de antivirales de acción directa (AAD) y fármacos con acción sobre el sistema nervioso central: Consideraciones en el perfil actual del paciente con hepatitis C Concomitant use of direct-acting antivirals (DAA) and central nervous system drugs in patients with hepatitis C virus infection

Autores/as

  • Antoni Sicras-Mainar Dirección Científica. Health economics and outcomes research. Atrys Health, Barcelona
  • Ramón Morillo-Verdugo Farmacéutico Especialista en Farmacia Hospitalaria. Hospital de Valme. AGS Sur de Sevilla

DOI:

https://doi.org/10.20882/adicciones.1551

Palabras clave:

VHC, sistema nervioso central, interacciones medicamentosas, antivirales de acción directa pangenotípicos. HCV, central nervous system, drug interactions, pangenotypic direct-acting antivirals.

Resumen

El objetivo fue determinar las potenciales interacciones farmacológicas (IF) entre los antivirales de acción-directa pangenotípicos (AADp) y la medicación-concomitante sobre el sistema nervioso central (SNC) asociada a los pacientes portadores del virus de la hepatitis C crónica (VHC). Se realizó un diseño transversal. Se incluyeron pacientes ≥18 años en tratamiento con AADp durante el año 2017. Las variables recogidas fueron: comorbilidad, medicación-concomitante (SNC) y potenciales IF. Los AADp analizados fueron: a) Sofosbuvir/Velpatasvir (SOF/VEL), b) Glecaprevir/Pibrentasvir (GLE/PIB) y c) Sofosbuvir/Velpatasvir/Voxilaprevir (SOF/VEL/VOX). Análisis-estadístico descriptivo. Se reclutaron 1.170 pacientes; edad-media de 60,1 años y el 56,4% varones. El promedio de medicamentos-concomitantes fue de 3,2 por paciente/año. El porcentaje de potenciales/posibles IF entre los AADp y los medicamentos-concomitantes sobre el SNC fueron: 2,7% contraindicaciones, 11,3% significativas y 4,2% débiles. En función de los AADp, estos porcentajes fueron los siguientes: SOF/VEL (2,7%; 0,0%; 4,4%), GLE/PIB (2,7%; 26,5%; 1,6%) y SOF/VEL/VOX (2,7%; 6,8%; 4,4%), respectivamente. Un tercio de los pacientes con VHC muestran un uso de medicación-concomitante de acción sobre el SNC. Será importante seleccionar un AADp que tenga una baja tasa de potenciales IF para simplificar el tratamiento. SOF/VEL se presenta como una buena alternativa en comparación con los AADp seleccionados, principalmente en el uso concomitante de antipsicóticos y analgésicos.
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.

Biografía del autor/a

Antoni Sicras-Mainar, Dirección Científica. Health economics and outcomes research. Atrys Health, Barcelona

Uso concomitante de antivirales de acción directa (AAD) y fármacos con acción sobre el sistema nervioso central: Consideraciones en el perfil actual del paciente con hepatitis C

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Publicado

2020-12-05

Número

Vol. 34 Núm. 4 (2022)

Sección

Originales