Use of psychiatric medication and drug interactions in patients with hcv infection treated with pangenotypic direct-acting antivirals.

Autor: Turnes, J., Garcia-Herola, A., Verdugo, R.M., Mendez, M., De Alvaro, C., Hernandez, C., Sicras-Mainar, A.
Zdroj: Digestive & Liver Disease; 2023 Supplement 1, Vol. 55, pS71-S71, 1p
Abstrakt: Previous studies have shown that nervous system (NS) drugs were the most prescribed in patients with chronic C-hepatitis. The aim of this sub-analysis was to analyze the presence and severity of drug-drug interactions (DDIs) in patients using antipsychotics and treated with Pangenotypic Direct-Acting Antivirals (pDAA) in a real-life cohort. Retrospective, multicenter, observational study, using the BIG-PAC database (Atrys Health), in adult HCV patients treated with Sofosbuvir/Velpatasvir [SOF/VEL] and Glecaprevir/Pibrentasvir [GLE/PIB] (years 2017-2020). Variables collected were: age, sex; fibrosis degree, addiction/substance abuse; pharmacotherapeutic; adverse events; type of pDAA prescribed and presence or absence of psychiatric co-medications. Potential DDIs between concomitant medication and pDAA were assessed using the University of Liverpool database. 1620 patients were included (median age: 54 years; men: 61%; F3/4: 32.4%). 61% had addictions/substance abuse. NS drugs were the most prescribed (35.8%): among those, psycholeptics (N05) accounted for 40% (being quetiapine the most represented). 12% of the total population was under antipsychotics (N05A), characterized by younger age and higher fibrosis degree (F3/F4) than the total population [median age: 53 years; men: 59%; F3/4: 44%]. 75% of patients with antipsychotics had addictions/substance abuse and 14% of patients with addictions/substance abuse were prescribed antipsychotics, being this percentage lower in the general population, 7%; p<0.001. In terms of potential interactions, 28% of patients with antipsychotics were at risk of DDIs with DAAs; this percentage is numerically higher in patients with addictions/substance abuse, 30% vs. 23% of the general population (p=0.336). Two adverse events were reported in the GLE/PIB treated group, 1 with quetiapine (resulting in DAA discontinuation) and 1 with paliperidone. No adverse events were reported in the group treated with SOF/VEL. In patients with C-hepatitis and treated with antipsychotics, the presence of potential interactions is high, requiring a comprehensive approach to their follow-up to achieve therapy optimization [ABSTRACT FROM AUTHOR]
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