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PLoS One. 2015 Apr 29;10(4):e0124139. doi: 10.1371/journal.pone.0124139. eCollection 2015.

Short and long-term effects of telaprevir on kidney function in patients with hepatitis C virus infection: a retrospective cohort study.

Author information

1
Division of Nephrology, Department of Medicine, Massachusetts General Hospital, Harvard University, Boston, MA, United States of America.
2
Department of Pharmacy, Massachusetts General Hospital, Harvard University, Boston, MA, United States of America.
3
Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA, United States of America.
4
Division of Infectious Diseases, Brigham and Women's Hospital, and Harvard Medical School, Boston, MA, United States of America.
5
Gastrointestinal Unit, Department of Medicine, Massachusetts General Hospital, Harvard University, Boston, MA, United States of America.
6
Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, Harvard University, Boston, MA, United States of America.

Abstract

BACKGROUND:

Recent reports suggest that telaprevir, a protease inhibitor used to treat hepatitis C infection, is associated with decline in kidney function during therapy, particularly in patients with baseline renal impairment.

METHODS:

Patients treated with telaprevir in a single healthcare network were retrospectively reviewed. Kidney function was determined at baseline, during therapy, and twelve weeks and twelve months after telaprevir discontinuation. Significant creatinine rise during therapy was defined as an increase in serum creatinine ≥ 0.3mg/dL from baseline during treatment with telaprevir.

RESULTS:

Between July 2011 to January 2013,seventy-eight patients began treatment. The majority completed the prescribed twelve weeks of telaprevir therapy; 32% discontinued due to side effects. The average rise in serum creatinine during therapy was 0.22mg/dL (standard deviation 0.22mg/dL). Thirty-one percent experienced a significant creatinine rise during therapy. Decline in estimated glomerular filtration rate (eGFR) was lower in those with baseline eGFR < 90 mL/min/1.73m2 compared to the group with baseline eGFR ≥ 90 mL/min/1.73m2 (12 vs. 18 mL/min/1.73m2, P = 0.047). Serum creatinine fully normalized by twelve weeks after cessation of telaprevir in 83% of patients, however experiencing a significant creatinine rise during telaprevir use was associated with a 6.6mL/min/1.73m2 decrease in estimated glomerular filtration rate at twelve months in an adjusted model.

CONCLUSIONS:

Decline in kidney function during therapy with telaprevir is common and is not associated with baseline eGFR < 90mL/min/1.73m2 as previously reported.

PMID:
25923243
PMCID:
PMC4414554
DOI:
10.1371/journal.pone.0124139
[Indexed for MEDLINE]
Free PMC Article

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