Efficacy and safety of ledipasvir/sofosbuvir for genotype 1b chronic hepatitis C patients with moderate renal impairment

• DOI: 10.1007/s12072-018-9859-9
• Publication Date: 2018-04-04T02:58:37Z
• Authors: Tomomi Okubo; Masanori Atsukawa; Akihito Tsubota; Hidenori Toyoda; Noritomo Shimada; Hiroshi Abe; Keizo Kato; Korenobu Hayama; Taeang Arai; Ai Nakagawa-Iwashita; Norio Itokawa; Chisa Kondo; Chiaki Kawamoto; Etsuko Iio; Yasuhito Tanaka; Takashi Kumada; Katsuhiko Iwakiri
• Keywords: Adult; Aged, 80 and over; Male; Fluorenes; Hepatitis B virus; 0303 health sciences; Genotype; Sustained Virologic Response; Hepatitis C, Chronic; Middle Aged; Antiviral Agents; 3. Good health; 03 medical and health sciences; Age Distribution; Creatinine; Drug Resistance, Viral; Humans; Benzimidazoles; Renal Insufficiency, Chronic; Sofosbuvir; Aged; Glomerular Filtration Rate; Retrospective Studies

To evaluate the efficacy and safety of ledipasvir and sofosbuvir therapy for genotype 1b in chronic hepatitis C patients with chronic kidney disease (CKD) stage 3.In a multicenter collaborative retrospective study, 706 patients who have received ledipasvir which is NS5A inhibitor, and sofosbuvir 400 mg which is NS5B nucleoside polymerase inhibitor daily for 12 weeks between September 2015 and January 2017 were subjected to this analysis. Virologic response and adverse events in patients with CKD stage 3 were compared with those in patients with CKD stages 1 and 2.The rates of sustained virologic response (SVR) were 97.0% in patients with CKD stage 1, 97.1% in patients with CKD stage 2, and 94.7% in patients with CKD stage 3, respectively. There were no significant differences in the SVR rates between CKD stages 1 and 2, and CKD stage 1 and stage 3. The incidence of adverse events over than grade 2 was 0% in patients with CKD stage 1, 0.5% in patients with CKD stage 2, and 3.0% in patients with CKD stage 3, respectively. For treatment and follow-up period, eGFR levels in the patients with CKD stage 3 were not worsened compared to those at baseline.This study suggested that the virologic response of ledipasvir and sofosbuvir in patients with CKD stage 3 was not inferior to those with CKD stages 1 and 2. In addition, administration of ledipasvir and sofosbuvir did not affect eGFR levels in the patients with CKD stage 3.