Drug–Drug Interactions of Newly Approved Direct-Acting Antiviral Agents in Patients with Hepatitis C

Abstract

Lu-Hua Gao, Qing-He Nie, Xi-Tai Zhao Center of Infectious Diseases, Second Affiliated Hospital, Air-Force Military Medical University, Xi'an 710038, People's Republic of ChinaCorrespondence: Qing-He NieCenter of Infectious Diseases, Second Affiliated Hospital, Air-Force Military Medical University, 569 Xinsi Road, Baqiao District, Xi'an 710038, People's Republic of ChinaEmail nhqxan2020@163.comAbstract: Hepatitis C is a major health problem worldwide, frequently resulting in cirrhosis and increasing the risk of hepatocellular carcinoma significantly. In recent years, the advent of direct-acting antivirals (DAAs) has dramatically improved the therapeutic outcomes in hepatitis C patients. In the last two years, several new DAA combinations have been approved for the treatment of the hepatitis C virus (HCV) infection, including elbasvir/grazoprevir, sofosbuvir/velpatasvir, sofosbuvir/velpatasvir/voxilaprevir, and glecaprevir/pibrentasvir. The newly approved DAA regimens may be prescribed with other drugs simultaneously, increasing the potential of pharmacokinetic interactions. Therefore, the knowledge and management of drug–drug interactions (DDIs) with DAAs should be considered a key issue in HCV therapy. This review summarizes researches of DDIs focusing on newly approved DAAs (elbasvir, grazoprevir, velpatasvir, voxilaprevir, glecaprevir, pibrentasvir) for patients undergoing HCV treatment to provide clinical consideration for comedication. With respect to DDIs, newly approved DAA regimens, including elbasvir/grazoprevir, sofosbuvir/velpatasvir, sofosbuvir/velpatasvir/voxilaprevir, and glecaprevir/pibrentasvir, are safely applicable.Keywords: drug–drug interaction, direct-acting antiviral, chronic hepatitis C, pharmacokinetic, comedication