Reduced-dose telaprevir-based triple antiviral therapy for recurrent hepatitis C after living donor liver transplantation

Toru Ikegami, Tomoharu Yoshizumi, Masaki Kato, Satomi Yamamoto, Takasuke Fukuhara, Yoshiharu Matsuura, Shota Nakamura, shinji itoh, Ken Shirabe, Yoshihiko Maehara

研究成果: ジャーナルへの寄稿記事

5 引用 (Scopus)

抄録

Introduction. The feasibility of telaprevir-based triple therapy for recurrent hepatitis C after liver transplantation (LT) has not been evaluated in Asian patients. Methods. Eleven Japanese patients received reduced-dose telaprevir (1500 mg) and adjusted-dose cyclosporine after LT. Six patients were nonresponders and three were transient responders to dual therapy. Results. Rapid viral response, early viral response, end of treatment response, and sustained viral response were achieved in 27.3%, 90.9%, 90.9%, and 81.8% of patients, respectively. One patient had viral breakthrough at week 8 with a T54A mutation in NS3. Deep sequence analysis showed that the T54A mutation reverted to wild-type after stopping telaprevir administration. Seven patients developed severe anemia, and six received blood transfusions (4Y20U). Their hemoglobin and estimated glomerular filtration rate remained significantly lower than pretreatment values at 36 weeks after treatment. Four patients developed plasma cell hepatitis after completing telaprevir treatment, and it was treated by increasing the immunosuppressants. Although the cyclosporine level/dose ratio was 2.7 times higher at week 4 than before treatment, it was 0.7 times lower at week 36. Conclusions. Reduced-dosed telaprevir-based triple antiviral therapy achieved a high viral clearance rate in Japanese patients after LT. Major adverse events included severe anemia, renal dysfunction, and plasma cell hepatitis.

元の言語英語
ページ(範囲)994-999
ページ数6
ジャーナルTransplantation
98
発行部数9
DOI
出版物ステータス出版済み - 1 1 2014

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Living Donors
Hepatitis C
Liver Transplantation
Antiviral Agents
Therapeutics
Plasma Cells
Cyclosporine
Hepatitis
Anemia
Mutation
telaprevir
Immunosuppressive Agents
Glomerular Filtration Rate
Blood Transfusion
Sequence Analysis
Hemoglobins
Kidney

All Science Journal Classification (ASJC) codes

  • Transplantation

これを引用

Reduced-dose telaprevir-based triple antiviral therapy for recurrent hepatitis C after living donor liver transplantation. / Ikegami, Toru; Yoshizumi, Tomoharu; Kato, Masaki; Yamamoto, Satomi; Fukuhara, Takasuke; Matsuura, Yoshiharu; Nakamura, Shota; itoh, shinji; Shirabe, Ken; Maehara, Yoshihiko.

:: Transplantation, 巻 98, 番号 9, 01.01.2014, p. 994-999.

研究成果: ジャーナルへの寄稿記事

Ikegami, Toru ; Yoshizumi, Tomoharu ; Kato, Masaki ; Yamamoto, Satomi ; Fukuhara, Takasuke ; Matsuura, Yoshiharu ; Nakamura, Shota ; itoh, shinji ; Shirabe, Ken ; Maehara, Yoshihiko. / Reduced-dose telaprevir-based triple antiviral therapy for recurrent hepatitis C after living donor liver transplantation. :: Transplantation. 2014 ; 巻 98, 番号 9. pp. 994-999.
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abstract = "Introduction. The feasibility of telaprevir-based triple therapy for recurrent hepatitis C after liver transplantation (LT) has not been evaluated in Asian patients. Methods. Eleven Japanese patients received reduced-dose telaprevir (1500 mg) and adjusted-dose cyclosporine after LT. Six patients were nonresponders and three were transient responders to dual therapy. Results. Rapid viral response, early viral response, end of treatment response, and sustained viral response were achieved in 27.3{\%}, 90.9{\%}, 90.9{\%}, and 81.8{\%} of patients, respectively. One patient had viral breakthrough at week 8 with a T54A mutation in NS3. Deep sequence analysis showed that the T54A mutation reverted to wild-type after stopping telaprevir administration. Seven patients developed severe anemia, and six received blood transfusions (4Y20U). Their hemoglobin and estimated glomerular filtration rate remained significantly lower than pretreatment values at 36 weeks after treatment. Four patients developed plasma cell hepatitis after completing telaprevir treatment, and it was treated by increasing the immunosuppressants. Although the cyclosporine level/dose ratio was 2.7 times higher at week 4 than before treatment, it was 0.7 times lower at week 36. Conclusions. Reduced-dosed telaprevir-based triple antiviral therapy achieved a high viral clearance rate in Japanese patients after LT. Major adverse events included severe anemia, renal dysfunction, and plasma cell hepatitis.",
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AU - Yoshizumi, Tomoharu

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AU - Fukuhara, Takasuke

AU - Matsuura, Yoshiharu

AU - Nakamura, Shota

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