title: Usefulness of combination therapy with Daclatasvir plus Asunaprevir in chronic hepatitis C patients with chronic kidney disease.
abstract: OBJECTIVE
  Combination therapy with Daclatasvir (DCV) plus Asunaprevir (ASV) has been proven effective in patients with chronic hepatitis C virus (HCV) infection. However, little is known as to the effect of this therapy in patients with reduced renal function. Focusing on CKD patients whose renal function has declined, the present trial addresses the efficacy and safety of this combination therapy in CKD patients with reduced estimated glomerular filtration rate (eGFR).
  
  
  METHODS
  The study design is a single-center, retrospective longitudinal observational study enrolling 106 patients with (n = 29) or without (n = 77) CKD. After the treatment with combined DCV with ASV for chronic HCV genotype 1b, patients were followed for a total of 48 weeks and the comparison was made in clinical parameters between the two groups.
  
  
  RESULTS
  (1) The majority of patients in both groups achieved sustained virological response at 24 weeks (90.8 % in the non-CKD group, and 93.1 % in the CKD). (2)The reduction rate in HCV-RNA levels 2 weeks after commencing the treatment was faster in the CKD group than that in the non-CKD group (81.8 vs. 79.2 %, p < 0.01). (3) Three patients in the CKD group and 6 patients in the non-CKD group withdrew from the treatment because of the adverse events.
  
  
  CONCLUSIONS
  Combination therapy with DCV plus ASV for chronic HCV genotype 1b infection is useful and tolerable, not only in patients with normal eGFR, but also in those with CKD with declined eGFR. Viral eradication at an early phase of the treatment appears to be faster in CKD patients.
authors: Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, 3-25-8 Nishi-shimbashi, Minato-ku, Tokyo, 105-8471, Japan. n-morisawa@jikei.ac.jp.|Division of Nephrology, Department of Internal Medicine, Saitama Red Cross Hospital, Saitama, Japan. n-morisawa@jikei.ac.jp.
authors: Norihiko
authors: http://orcid.org/0000-0002-1761-3888
authors: N
authors: Morisawa
authors: Division of Gastroenterology and Hepatology, Department of Internal Medicine, Saitama Red Cross Hospital, Saitama, Japan.
authors: Yohei
authors: Y
authors: Koshima
authors: Division of Nephrology, Department of Internal Medicine, Saitama Red Cross Hospital, Saitama, Japan.
authors: Jun-Ichi
authors: JI
authors: Satoh
authors: Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, 3-25-8 Nishi-shimbashi, Minato-ku, Tokyo, 105-8471, Japan.
authors: Yukio
authors: Y
authors: Maruyama
authors: Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, 3-25-8 Nishi-shimbashi, Minato-ku, Tokyo, 105-8471, Japan.
authors: Satoru
authors: S
authors: Kuriyama
authors: Division of Nephrology and Hypertension, Department of Internal Medicine, Jikei University School of Medicine, 3-25-8 Nishi-shimbashi, Minato-ku, Tokyo, 105-8471, Japan.
authors: Takashi
authors: T
authors: Yokoo
authors: Division of Nephrology, Department of Internal Medicine, Saitama Red Cross Hospital, Saitama, Japan.
authors: Morimasa
authors: M
authors: Amemiya
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002219:Carbamates; D004359:Drug Therapy, Combination; D005260:Female; D005838:Genotype; D005919:Glomerular Filtration Rate; D016174:Hepacivirus / Q000187:drug effects* / Q000235:genetics; D019698:Hepatitis C, Chronic / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D007093:Imidazoles / Q000009:adverse effects / Q000627:therapeutic use*; D007546:Isoquinolines / Q000009:adverse effects / Q000627:therapeutic use*; D007564:Japan; D007668:Kidney / Q000503:physiopathology*; D008137:Longitudinal Studies; D008297:Male; D011759:Pyrrolidines; D012367:RNA, Viral / Q000097:blood / Q000235:genetics; D051436:Renal Insufficiency, Chronic / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D012189:Retrospective Studies; D013449:Sulfonamides / Q000009:adverse effects / Q000627:therapeutic use*; D000072230:Sustained Virologic Response; D013997:Time Factors; D016896:Treatment Outcome; D014633:Valine / Q000031:analogs & derivatives; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D002219:Carbamates; D007093:Imidazoles; D007546:Isoquinolines; D011759:Pyrrolidines; D012367:RNA, Viral; D013449:Sulfonamides; D014633:Valine; C549273:daclatasvir; C571889:asunaprevir
keywords: Asunaprevir; Chronic kidney disease; Daclatasvir; Hepatitis C infection