Sofosbuvir and risk of estimated glomerular filtration rate decline or end-stage renal disease in patients with renal impairment

© 2022 The Authors. Alimentary Pharmacology & Therapeutics published by John Wiley & Sons Ltd..

BACKGROUND: Sofosbuvir, a prodrug nucleoside inhibitor of hepatitis C virus, has a predominant circulating metabolite that is renally eliminated. Whether sofosbuvir is associated with chronic kidney disease (CKD) progression is not well understood.

METHODS: We performed a retrospective analysis of patients with estimated glomerular filtration rate (eGFR) 30-89 mL/min/1.73 m2 treated with sofosbuvir in 76 Phase 2/3 registrational trials. We evaluated eGFR at each study visit. Separately, we performed a retrospective analysis of an administrative claims database (IQVIA PharMetrics Plus™) to compare the risk of incident end-stage renal disease (ESRD) associated with the use of sofosbuvir or non-sofosbuvir regimens among patients with CKD using propensity score methods. Exposure, CKD status and outcomes were determined using diagnosis and medication claim codes. Cox proportional hazards methods were used to estimate ESRD risk.

RESULTS: Among 4642 trial participants with baseline stage 2 CKD (eGFR 60-89 ml/min/1.73 m2 ) and 682 trial participants with stage 3 CKD (eGFR 30-59 ml/min/1.73 m2 ) mean (SD) eGFR improved from baseline to 4 weeks post-treatment (+0.7 [9.3] and +2.6 [8.8] ml/min/1.73 m2 , respectively; p < 0.001 each). In the second analysis, among 2042 patients with CKD receiving sofosbuvir-based regimens compared to 431 receiving non-sofosbuvir-based regimens, after adjusting for baseline covariates and weighting based on treatment propensity scores, there was no significant difference in risk of ESRD (adjusted HR = 0.85, 95% CI: 0.51-1.42).

CONCLUSIONS: Clinical trial participants with CKD did not experience worsening eGFR during sofosbuvir-based treatment, and sofosbuvir was not associated with an increased risk of ESRD in patients with CKD in a nationally-representative administrative claims database.

Errataetall:

CommentIn: Aliment Pharmacol Ther. 2022 Apr;55(8):1052-1053. - PMID 35362131

Medienart:

E-Artikel

Erscheinungsjahr:

2022

Erschienen:

2022

Enthalten in:

Zur Gesamtaufnahme - volume:55

Enthalten in:

Alimentary pharmacology & therapeutics - 55(2022), 9 vom: 04. Mai, Seite 1169-1178

Sprache:

Englisch

Beteiligte Personen:

Sulkowski, Mark [VerfasserIn]
Telep, Laura E [VerfasserIn]
Colombo, Massimo [VerfasserIn]
Durand, Francois [VerfasserIn]
Reddy, K Rajender [VerfasserIn]
Lawitz, Eric [VerfasserIn]
Bourlière, Marc [VerfasserIn]
Cheinquer, Nelson [VerfasserIn]
Scherbakovsky, Stacey [VerfasserIn]
Ni, Liyun [VerfasserIn]
Force, Lindsey [VerfasserIn]
Ramroth, Heribert [VerfasserIn]
Gaggar, Anuj [VerfasserIn]
Chokkalingam, Anand P [VerfasserIn]
Sise, Meghan E [VerfasserIn]

Links:

Volltext

Themen:

Antiviral Agents
Chronic kidney disease
Clinical Trial
Dialysis
Direct-acting antiviral
End-stage renal disease
GS-331007
Journal Article
Research Support, Non-U.S. Gov't
Sofosbuvir
WJ6CA3ZU8B

Anmerkungen:

Date Completed 19.04.2022

Date Revised 11.11.2023

published: Print-Electronic

CommentIn: Aliment Pharmacol Ther. 2022 Apr;55(8):1052-1053. - PMID 35362131

Citation Status MEDLINE

doi:

10.1111/apt.16830

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM33766501X