title: Simeprevir with peginterferon and ribavirin induced interstitial pneumonitis: first case report.
abstract: The effectiveness of hepatitis C treatment has improved with the development of interferon (IFN), and it has drastically improved with the development of peg-interferon-α (PEG-IFN) in combination with ribavirin (RBV) and, more recently, with the addition of a protease inhibitor. Simeprevir, which is a second-generation protease inhibitor, has shown clinically favorable safety and tolerability profiles. Simeprevir received its first global approval in Japan in September 2013 for the treatment of genotype 1 chronic hepatitis C in combination with PEG-IFN and RBV. One serious adverse event associated with IFN therapy is interstitial pneumonitis, which can be fatal. We experienced a patient with interstitial pneumonitis that was induced by simeprevir with PEG-IFN and RBV therapy for chronic hepatitis C in the early stages of therapy (8 wk after initiating therapy). This is the first case report of interstitial pneumonitis with simeprevir with PEG-IFN and RBV in the world. In addition, it is very interesting that the onset of interstitial pneumonitis was earlier than that in conventional PEG-IFN and RBV therapy. This finding suggests that simeprevir augments the adverse event. We present this case report in light of relevant literature on interstitial pneumonitis with conventional PEG-IFN and RBV therapy.
authors.affiliation: Katsuyoshi Tamaki, Department of Hepatology, Tourai-kai Okubo Hospital, Tokushima 770-0923, Japan.
authors.forename: Katsuyoshi
authors.initials: K
authors.lastname: Tamaki
authors.affiliation: Katsuyoshi Tamaki, Department of Hepatology, Tourai-kai Okubo Hospital, Tokushima 770-0923, Japan.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Okubo
mesh_terms: D000368:Aged; D000998:Antiviral Agents / Q000009:adverse effects*; D004359:Drug Therapy, Combination; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage; D019698:Hepatitis C, Chronic / Q000175:diagnosis / Q000188:drug therapy*; D006575:Heterocyclic Compounds, 3-Ring / Q000009:adverse effects*; D006801:Humans; D016898:Interferon-alpha / Q000009:adverse effects*; D017563:Lung Diseases, Interstitial / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D011092:Polyethylene Glycols / Q000009:adverse effects*; D011239:Prednisolone / Q000008:administration & dosage; D011994:Recombinant Proteins / Q000009:adverse effects; D012254:Ribavirin / Q000009:adverse effects*; D000069616:Simeprevir; D013449:Sulfonamides / Q000009:adverse effects*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D005938:Glucocorticoids; D006575:Heterocyclic Compounds, 3-Ring; D016898:Interferon-alpha; D011994:Recombinant Proteins; D013449:Sulfonamides; D011092:Polyethylene Glycols; D012254:Ribavirin; D011239:Prednisolone; D000069616:Simeprevir; C100416:peginterferon alfa-2a
keywords: Adverse events; Chronic hepatitis C; Interstitial pneumonitis; Peg-interferon-α; Simeprevir