Aplastic Anemia and Severe Myelosuppression with Boceprevir or Simeprevir-Containing Hepatitis C Virus Treatment
Ann. hepatol
; Ann. hepatol;16(2): 312-317, Mar.-Apr. 2017. tab, graf
Article
de En
| LILACS
| ID: biblio-887238
Bibliothèque responsable:
BR1.1
ABSTRACT
ABSTRACT The addition of the new protease inhibitors (PIs) to peg-interferon (IFN) and ribavirin (RBV), approved for chronic hepatitis C, has clearly improved sustained virological response (SVR) rates although several adverse events have been reported with this regimens, including mild hematological toxicity. Moreover, severe pancytopenia and aplastic anemia during triple therapy with telaprevir has recently been described in seven patients. We report here two cases of severe agranulocytosis/aplastic anemia using boceprevir or simeprevir in interferon-based combination and 2 additional cases of severe myelosupression in IFN-free therapy with sofosbuvir and simeprevir plus RBV. Our observations suggest that PIs could have a sort of class-effect in developing severe hematologic toxicity or, at least, an additive interaction with other potentially myelotoxic agents such as IFN or RBV that are used in the classical regimens against HCV. Unfortunately, the mechanisms behind this phenomenon are currently unknown. In conclusion, given the lifethreatening character of these complications, close monitoring is mandatory in patients under PIs based therapy to promptly detect serious hematological toxicities and to carefully evaluate treatment discontinuation. Prospective studies assessing the usefulness of RBV in the era of new IFN-free combinations are needed.
Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
LILACS
Sujet principal:
Inhibiteurs de protéases
/
Maladies de la moelle osseuse
/
Proline
/
Hépatite C
/
Siméprévir
/
Anémie aplasique
Type d'étude:
Diagnostic_studies
/
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limites:
Humans
Langue:
En
Journal:
Ann. hepatol
Sujet du journal:
GASTROENTEROLOGIA
Année:
2017
Type de document:
Article
Pays d'affiliation:
Espagne
Pays de publication:
Mexique