icon-folder.gif   Conference Reports for NATAP  
  The International Liver Congress™
EASL - European Association for the
Study of the Liver
June 22-26 2022
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Don't Delay DAAs in People
Taking Antiepileptics, Elite Experts Advise

  EASL International Liver Congress 2022, London, June 22-26, 2022
Mark Mascolini
Analysis of the University of Liverpool HEP Interaction Checker (www.hep-druginteractions.org) by elite pharmacology experts found almost 100,000 queries about potential interactions between direct-acting antivirals (DAAs) for hepatitis C infection and antiepileptic agents (eiAE) [1]. These drug-interaction leaders believe recent findings show clinicians do not have to delay DAA therapy in people taking eiAEs.
Pharmacology experts from Nijmegen, Utrecht, Liverpool, and other centers noted that interactions between DAAs and eiAEs remain among the most complex clinicians face. But recent research shows that agents from these classes can be successfully combined [2].
Aiming to see how often health professionals around the world ask Liverpool's HEP Interaction Checker about DAA-eiAE interactions, these investigators identified drug-drug interaction queries involving the eiAEs carbamazepine, phenytoin, phenobarbital, primidone, oxcarbazepine, and eslicarbazepine sent to the site between July 1, 2017 and September 30, 2021. All database queries are anonymous, but the country must be identified.
Through 51 months the database logged 94,695 DAA-eiAE queries from 98 countries. Among DAAs, the highest proportion of queries involved glecaprevir/pibrentasvir (23.3%) and sofosbuvir/velpatasvir (22.3%). The eiAEs most frequently searched were carbamazepine (37.9%), phenytoin (19.9%), and oxcarbazepine (18.7%). The DAA-eiAE combination that elicited the most queries (7773) was glecaprevir/pibrentasvir and carbamazepine. Most request for interaction data came from the United States, the United Kingdom, Spain, Italy, Germany, Australia, and Russia.
David Burger, David Back, and coauthors believe their findings underline "a huge demand globally" for guidance on potential interactions between DAAs and eiAEs. They stressed that prior contraindications between individual DAAs and eiAEs have been removed as more data became available. "HCV treatment should no longer be deferred," the researchers advised, "when an eiAE is on board."
1. Burger D, Back D, Martin J, et al. Requests for drug-drug interaction data on direct-acting antivirals and enzyme inducing anti-epileptic agents: an overview of the HEP interaction checker database of the University of Liverpool. EASL International Liver Congress 2022, London, June 22-26, 2022. Abstract FRI383.
2. Marcos-Fosch C, Cabezas J, Crespo J, Buti M. Anti-epileptic drugs and hepatitis C therapy: Real-world experience. J Hepatol. 2021;75:984-985. doi: 10.1016/j.jhep.2021.05.040.