Adverse Reactions Common with Hep C Treatment in Older Patients

Patients aged 65 years and older who have hepatitis C can benefit from treatment with direct-acting antiviral medications, but adverse reactions are common and often require adjustments, according to a recent study.

Elderly patients are more susceptible to side effects from combining medications than patients younger than 65. Therefore, it’s important for physicians to personalize hepatitis C treatment for these patients based on their current medications.
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To conduct their study, researchers followed 121 patients aged 65 years and older who were treated for hepatitis C at Coruña University Hospital and Hospital Álvaro Cunqueiro in Spain from August 2012 to October 2015.

The majority of patients were taking other medications, including proton-pump inhibitors and statins. To ensure limited drug interactions, researchers modified one-third of the patients’ hepatitis C treatments—this usually meant ceasing their previously prescribed medication.

Researchers assigned each patient 1 of 12 treatment regimens based on the patients’ current medication. The 2 most common combinations were (1) ombitasvir, paritaprevir, ritonavir, and dasabuvir with or without ribavirin and (2) ledipasvir and sofosbuvir with or without ribavirin.

After a 3-to-6-month follow-up, researchers found that 95% of patients had a sustained viral response but 44% had experienced side effects such as anemia, fatigue, dry mucous, and elevated bilirubin.

“We need more data about these new treatments in the elderly,” researchers concluded. “I think we can treat these patients, but caution for interactions and adverse events is required.”

—Amanda Balbi

Reference:

Berta Pernas. Paper presented at: International Conference on Viral Hepatitis (ICVH) 2016. Presented March 14, 2016.