Safety of sofosbuvir-based regimens after liver transplantation: longitudinal assessment of renal function in the prospective ANRS CO23 CUPILT study

被引：6

作者：

Anty, R. ^{[1
,2
]}

Favre, G. ^{[3
,4
]}

Coilly, A. ^{[5
]}

Rossignol, E. ^{[6
,7
]}

Houssel-Debry, P. ^{[6
]}

Duvoux, C. ^{[8
]}

De Ledinghen, V ^{[9
]}

Di Martino, V ^{[10
]}

Leroy, V ^{[11
]}

Radenne, S. ^{[12
]}

Komar, N. ^{[13
]}

Canva, V ^{[14
]}

D'Alteroche, L. ^{[15
]}

Durand, F. ^{[16
]}

Dumortier, J. ^{[17
]}

Lebray, P. ^{[18
]}

Besch, C. ^{[19
]}

Tran, A. ^{[1
,2
]}

Canivet, C. M. ^{[1
,2
]}

Botta-Fridlund, D. ^{[20
]}

Montialoux, H. ^{[21
]}

Moreno, C. ^{[22
]}

Conti, F.

Silvain, C. ^{[23
]}

Perre, P. ^{[24
]}

Habersetzer, F. ^{[25
]}

Abergel, A. ^{[26
]}

Debette-Gratien, M. ^{[27
]}

Dharancy, S. ^{[14
]}

Esnault, V. L. M. ^{[3
,4
]}

Fougerou-Leurent, C.

Cagnot, C. ^{[28
]}

Diallo, A. ^{[29
]}

Veislinger, A. ^{[6
,7
]}

Danjou, H. ^{[6
,7
]}

Samuel, D. ^{[5
]}

Pageaux, G-P ^{[29
]}

Duclos-Vallee, J-C ^{[5
]}

机构：

[1] Ctr Hosp Univ Nice, Pole Reference Hepatite C, Nice, France

[2] Hepat Complicat Obes, U1065, Team 8, Nice, France

[3] Serv Nephrol Dialyses Transplantat, Nice, France

[4] Univ Cote Azur, Fac Med, Lab Physiomed Mol, CNRS,UMR 7370, Nice, France

[5] Paris Sud Univ Hosp, AP HP, Paul Brousse Hosp, DHU Hepatinov Villejuif, Villejuif, France

[6] Rennes Univ Hosp, Pontchaillou Hosp, Rennes, France

[7] INSERM, CIC 1414, Rennes, France

[8] Henry Mondor Hosp, AP HP, Creteil, France

[9] Bordeaux Univ Hosp, Haut Leveque Hosp, INSERM, U1053, Bordeaux, France

[10] Besancon Univ Hosp, Jean Minjoz Hosp, Besancon, France

[11] Grenoble Univ Hosp, Albert Michallon Hosp, Grenoble, France

[12] Croix Rousse Hosp, HCL, Lyon, France

[13] Toulouse Univ Hosp, Toulouse, France

[14] Hop Huriez, Serv Hepatol, Lille, France

[15] Tours Univ Hosp, Tours, France

[16] Beaujon Hosp, AP HP, Clichy, France

[17] Hop Edouard Herriot, HCL, Lyon, France

[18] Pitie Salpetriere, AP HP, Paris, France

[19] Strasbourg Univ Hosp, Strasbourg, France

[20] Marseille Univ Hosp, La Conception Hosp, Marseille, France

[21] CHU Charles Nicolle, Serv Hepatogastroenterol, Rouen, France

[22] Bruxelles Univ Libre, Brussels, Belgium

[23] Univ Poitiers Hosp, Poitiers, France

[24] CHD Vendee, Serv Med Interne, La Roche Sur Yon, France

[25] Hop Univ Strasbourg, LabEx HepSYS, INSERM, U1110, INSERM U, France

[26] CHU Estaing, Pole Digestif, Clermont Ferrand, France

[27] CHU Dupuytren, Serv Hepatogastroenterol & Nutr, Limoges, France

[28] ANRS France Rech Nord Sud Sida Hiv Hepatites, Paris, France

[29] Montpellier Univ Hosp, St Eloi Hosp, Montpellier, France

来源：

ALIMENTARY PHARMACOLOGY & THERAPEUTICS | 2018年 / 47卷 / 12期

关键词：

GLOMERULAR-FILTRATION-RATE; ACTING ANTIVIRAL AGENTS; C VIRUS-INFECTION; HEPATITIS-C; GENOTYPE; RECIPIENTS; RIBAVIRIN; KIDNEY; EXPERIENCE; EFFICACY;

D O I：

10.1111/apt.14639

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background: In liver transplant recipients with hepatitis C virus recurrence, there is concern about renal safety of sofosbuvir-based regimens. Changes in serum creatinine or in the estimated glomerular filtration rate (eGFR) under treatment are used to look for possible renal toxicity. However, serum creatinine and eGFR are highly variable. Aim: To analyse renal function trajectory with numerous assays of serum creatinine over a long period of time. Methods: In a multicentre cohort of 139 patients, the eGFR was obtained from serum creatinine using the Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI) equation. Slopes of eGFR were defined as a change in eGFR during a period divided by time. Pre-treatment, on-treatment and post-treatment periods were 9 months, 3-9 months and 4.5 months. Interactions between eGFR slopes and the pre-treatment eGFR, use of ribavirin or mycophenolate mofetil, and stage of fibrosis were addressed. On-treatment eGFR slopes were separated in tertiles. Pre- and post-treatment eGFR slopes were compared globally and according to tertiles. Results: The post-treatment eGFR slope was significantly better than pre-treatment eGFR slope (+0.18 (IQR -0.76 to +1.32) vs -0.11 (IQR -1.01 to +0.73) mL/min/1.73 m(2)/month, P=0.03) independently of the pre-treatment eGFR (P=0.99), ribavirin administration (P=0.26), mycophenolate mofetil administration (P=0.51) and stage of fibrosis (F3 and F4 vs lower stages, P=0.18; F4 vs lower stages, P=0.08; F4 Child-Pugh B and C vs lower stages, P=0.38). Tertiles of on-treatment eGFR slopes were -1.71 (IQR -2.54 to -1.48), -0.78 (IQR -1.03 to -0.36) and +0.75 (IQR +0.28 to +1.47) mL/min/1.73 m(2)/month. Pre- and post-treatment eGFR slopes were not significantly different according to tertiles (respectively, P=0.34, 0.08, 0.73). Conclusion: The eGFR varies during treatment and gives a confusing picture of the renal safety of sofosbuvir-based regimens. In contrast, longitudinal assessment of the eGFR shows a rising trajectory over longer time, meaning that these therapies are safe for the kidneys in our cohort of liver transplant recipients.

引用

页码：1682 / 1689

页数：8

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