Effectiveness and safety of protease inhibitors for the hepatitis C treatment in a hospital of South Brazil: real life data

Aline Bianca Borba Mattana; Karin Hepp Schwambach; Alberi Adolfo Feltrin; Mareni Rocha Farias; Carine Raquel Blatt

Aline Bianca Borba Mattana Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brasil
Karin Hepp Schwambach Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brasil
Alberi Adolfo Feltrin Pharmacist of the Center for the Application and Monitoring of Injectable Medicines (CAMMI) Conceição Hospitalar Group
Mareni Rocha Farias Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brasil
Carine Raquel Blatt Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brasil

Keywords: Hepatitis C, Drug-related side effects and adverse reactions, Treatment Outcome

Abstract

Introduction: The combination of Inhibitors of protease boceprevir (BOC) or telaprevir (TLV) concomitantly with peginterferon (PEG) and ribavirin (RBV) constitute the triple therapy (TT) for Hepatitis C treatment. Objective: To describe the experience of the TT treatment of chronic hepatitis C patients, besides discussing safety issues, in real life. Methods: Observational and retrospective study with 180 patients attended in a specialized center, between July 2014 and December 2015. Were evaluated variables as gender, age, access to drugs, pattern of alcohol consumption, pathway of contamination reported by the patient, previous treatment, degree of fibrosis, treatment regimen, treatment interruption and reason and Sustained Viral Response (SVR). Adverse Drug Reactions (ADRs) were collect through monthly self-report by the patient to the pharmacist. Results: 65 patients used BOC and 115 TLV, and the mean age was 54.20 (BOC) and 53.92 (TLV) years. End of treatment rate was 52.3% (BOC) and 53.3% (TLV). ADRs occurred in 18.5% of the patients (BOC) and 13.9% (TLV), being more frequent the severe anemia. Erythropoietin (EPO) used in 45.4% (BOC) and 58.2% (TLV). SVR rate calculated by intention to treat was 38.5% (BOC) e 50.4% (TLV). Conclusion: This study has shown that the effectiveness of TT is not significantly higher than double therapy and is lower than the reported in clinical trials. High dropout rates due to ADRs have been demonstrated, as well as a lower SVR found in clinical trials.