461. Prediction and its management of severe anemia in chronic hepatitis C patients treated with telaprevir-based triple therapy
Session: Poster Abstract Session: Prevention and Treatment of Viral Infections
Thursday, October 3, 2013
Room: The Moscone Center: Poster Hall C
Background: Anemia is a common adverse effect of telaprevir (TVR) in combination with pegylated interferon (PEG-IFN) α and ribavirin (RBV) therapy. It occurs at a higher incidence with the TVR relative to PEG-IFNα and RBV alone. We herein evaluate the baseline and on-treatment predictors of the development of severe anemia by chronic hepatitis C virus (HCV) patients receiving TVR-based triple therapy.

Methods: This prospective, multicenter study consisted of 292 patients (median age: 62 years) infected with HCV genotype 1. All received 12 weeks of TVR in combination with 24 weeks of PEG-IFNα2b and RBV. The definition of severe anemia during antiviral treatment is hemoglobin (Hb) <85 g/L.

Results: 101 (34.6%) patients developed severe anemia during the treatment period. Multivariable logistic regression analysis of possible pretreatment predictors of the development of severe anemia extracted baseline Hb<135 g/L (Hazard ratio [HR], 2.53; P=0.0013), estimated glomerular filtration rate <80 mL/min/1.73m2 (HR, 1.83; P=0.0265), and inosine triphosphatase (ITPA) CC genotype (rs1127354) (HR, 2.91; P=0.0024). For patients with ITPA CC (n=227), multivariable logistic regression analysis of possible pretreatment and on-treatment predictors of the development of severe anemia extracted Hb level at week 2 (HR, 0.96; P=0.0085) and the initial four weeks of weight-adjusted TVR (HR, 1.05; P=0.0281).

Conclusion:  ITPA polymorphism (rs1127354) is useful for predicting the development of severe anemia, in particular, careful attention should be given to the initial weight-adjusted dosage of TVR for patients with ITPA CC. (Research collaboration with The Kyushu University Liver Disease Study (KULDS) Group)

Eiichi Ogawa, MD., PhD., Norihiro Furusyo, MD., PhD., Masayuki Murata, MD., PhD., Hiroaki Ikezaki, MD., Satoshi Hiramine, MD. and Jun Hayashi, MD., PhD., Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan

Disclosures:

E. Ogawa, None

N. Furusyo, None

M. Murata, None

H. Ikezaki, None

S. Hiramine, None

J. Hayashi, None

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