Telaprevir versus simeprevir for the treatment of recurrent hepatitis C after living donor liver transplantation

Toru Ikegami, Tomoharu Yoshizumi, Yoshihro Yoshida, Takeshi Kurihara, Norifumi Harimoto, shinji itoh, Masahiro Shimokawa, Takasuke Fukuhara, Ken Shirabe, Yoshihiko Maehara

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Abstract

Aim: Our aim was to evaluate the clinical outcomes of telaprevir (TVR)- or simeprevir (SMV)-based triple therapy for recurrent hepatitis C after living donor liver transplantation. Methods: Twenty-six patients received antiviral therapy, consisting of either TVR (n=12) or SMV (n=14) in combination with pegylated interferon and ribavirin, plus cyclosporin. Results: More patients had a dose reduction of the direct-acting agent (36.3% vs 0.0%, P=0.02) or required blood transfusion for anemia (58.3% vs 7.1%, P<0.01) in the TVR group. The cyclosporin trough/dose ratio increased significantly from week 0 to week 4 in the TVR group (1.6±0.4 to 5.1±2.0, P<0.01), but not in the SMV group (1.2±0.3 to 1.3±0.2, P=0.68). The 24-week cumulative viral clearance rate was 91.7% and 85.7% in the TVR and in SMV groups, respectively. The early viral response and sustained viral response rates were 91.7% and 83.3%, respectively, in the TVR group, compared with 85.7% and 64.3%, respectively, in the SMV group. Interferon-mediated graft dysfunction occurred in four and five patients in the TVR and SMV groups, respectively; two patients were treated by oral steroids, five by steroid pulse and two by thymoglobulin, resulting in viral breakthrough in one case. Conclusion: SMV-based triple therapy was associated with fewer adverse events and drug interactions with cyclosporin, and possibly less antiviral properties to TVR. Interferon-mediated graft dysfunction is a significant clinical problem that warrants particular caution following living donor liver transplantation.

Original languageEnglish
Pages (from-to)E136-E145
JournalHepatology Research
Volume46
Issue number3
DOIs
Publication statusPublished - Mar 1 2016

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Living Donors
Hepatitis C
Liver Transplantation
Interferons
Cyclosporine
Therapeutics
Antiviral Agents
Steroids
Transplants
telaprevir
Simeprevir
Ribavirin
Drug Interactions
Blood Transfusion
Anemia

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Infectious Diseases

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Telaprevir versus simeprevir for the treatment of recurrent hepatitis C after living donor liver transplantation. / Ikegami, Toru; Yoshizumi, Tomoharu; Yoshida, Yoshihro; Kurihara, Takeshi; Harimoto, Norifumi; itoh, shinji; Shimokawa, Masahiro; Fukuhara, Takasuke; Shirabe, Ken; Maehara, Yoshihiko.

In: Hepatology Research, Vol. 46, No. 3, 01.03.2016, p. E136-E145.

Research output: Contribution to journalArticle

Ikegami, T, Yoshizumi, T, Yoshida, Y, Kurihara, T, Harimoto, N, itoh, S, Shimokawa, M, Fukuhara, T, Shirabe, K & Maehara, Y 2016, 'Telaprevir versus simeprevir for the treatment of recurrent hepatitis C after living donor liver transplantation', Hepatology Research, vol. 46, no. 3, pp. E136-E145. https://doi.org/10.1111/hepr.12546
Ikegami, Toru ; Yoshizumi, Tomoharu ; Yoshida, Yoshihro ; Kurihara, Takeshi ; Harimoto, Norifumi ; itoh, shinji ; Shimokawa, Masahiro ; Fukuhara, Takasuke ; Shirabe, Ken ; Maehara, Yoshihiko. / Telaprevir versus simeprevir for the treatment of recurrent hepatitis C after living donor liver transplantation. In: Hepatology Research. 2016 ; Vol. 46, No. 3. pp. E136-E145.
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AU - Yoshizumi, Tomoharu

AU - Yoshida, Yoshihro

AU - Kurihara, Takeshi

AU - Harimoto, Norifumi

AU - itoh, shinji

AU - Shimokawa, Masahiro

AU - Fukuhara, Takasuke

AU - Shirabe, Ken

AU - Maehara, Yoshihiko

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