The liver is, understandably, ground zero when it comes to the hepatitis C virus (HCV). However, other body organs are not without consequences from this disease. There is a strong association between hepatitis C and chronic kidney disease.
This combination of HCV and kidney disease presents challenges for treatment, since hepatitis C negatively affects the survival of dialysis and kidney transplant patients. Traditionally in the past, treatment of HCV in kidney disease patients tended to have a low success rates (in part due to high dropout rates). New HCV medications approved in the last few years offer new hope to these patients with comorbidities.
A new drug combination from Merck in a single tablet, containing the medications grazoprevir and elbasvir, shows strong results at the Phase 2 and Phase 3 clinical trial level. This drug combo has been used to treat HCV in patients with stage 4 or stage 5 chronic kidney disease. The latest research presented at the recent Kidney Week 2015, the Annual Meeting of the American Society of Nephrology, indicates a cure rate of 98.6% after the 12-week treatment with grazoprevir and elbasvir. Grazoprevir is a NS3/4A protease inhibitor and elbasvir is an NS5A replication complex inhibitor.
This medication combination is on-track for FDA approval, which should lead to new treatment options for this difficult-to-treat sub-group of HCV patients who also have chronic kidney disease.
Stephen C. Vogt, Pharm.D.
President and CEO
BioPlus Specialty Pharmacy
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Azmi AN, Tan S-S, Mohamed R. Hepatitis C and kidney disease: an overview and approach to management. World J Hepatol 2015;7(1):78-92.
Melville NA. Grazoprevir, elbasvir combination effective for patients with hepatitis C, kidney disease: presented at Kidney Week. DG News November 10, 2015.