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Efficacy and Safety of Daclatasvir and Asunaprevir Combination Therapy in Elderly Chronic Hepatitis C Patients
J. Kor. Soc. Health-syst. Pharm. 2018;35:453-462
Published online November 30, 2018;  https://doi.org/10.32429/jkshp.2018.35.4.007
© 2018 Korean Society of Health-System Pharmacists

You Kyung Parka,†, Su Jin Shina, You Ock Choia, Hye Jung Choib, Jin Suk Kanga and Shin-Yi Hwangboa

Department of Pharmacy, Seoul St. Mary’s Hospital, The Catholic University of Korea 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Koreaa
Department of Pharmacy, St. Paul's Hospital, The Catholic University of Korea 180 Wangsan-ro, Dongdaemun-gu, Seoul, 02559, Republic of Koreab
Correspondence to: You Kyung Park, Tel:02-2258-2542, E-mail:ykpark@cmcnu.or.kr
Received April 3, 2018; Revised May 21, 2018; Accepted September 14, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background : The prevalence of chronic hepatitis C virus (HCV) tends to be higher in the elderly. Pegylated interferon and ribavirin therapy (Peg-IFN/RBV) was recommended as the first-line treatment in the past decades, but this regimen showed unsatisfactory results in terms of safety and efficacy especially in elderly patients. Recently, it was demonstrated that dual therapy with daclatasvir and asunaprevir was well tolerated and led to high sustained virological response (SVR) rates, irrespective of age. We conducted a study to evaluate the efficacy and safety of daclatasvir plus asunaprevir by involving elderly patients aged above 65 years.
Methods : We retrospectively analyzed clinical data from chronic hepatitis C virus (HCV) genotype 1b patients treated with daclatasvir plus asunaprevir from September 2015 to December 2016 at Seoul St. Mary’s hospital. The patients were divided into two groups as elderly patients (older than 65 years) and non-elderly patients (younger than 65 years) and compared the efficacy and safety.
Results : A total of 112 patients were treated with daclatasvir plus asunaprevir for chronic hepatitis C. Among them, 101 patients completed the whole treatment, and in 88 patients the amount of HCV RNA was measured after 12 weeks of treatment. There was no significant difference in SVR at 12 weeks between both the groups (p=0.68). Typically, 91.4%(32/35) of elderly patients and 94.3%(50/53) of non-elderly patients achieved SVR12. Common adverse events included elevation in transaminase level, headache, and gastrointestinal disorders. There was no statistical difference in the symptoms between the two groups.
Conclusions : The combination therapy with daclatasvir plus asunaprevir exhibited similar rates of SVR12 in HCV elderly patients without leading to further adverse events compared to non-elderly patients. Therefore, it is proposed that daclatasvir plus asunaprevir therapy could be considered as an effective and safe treatment, even in patients aged over 65 years.
Keywords : Chronic hepatitis C, DAA (Direct Acting Antiviral Agents), Daclatasvir, Asunaprevir


February 2019, 36 (1)