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Naik GS, Tyagi MG. A pharmacological profile of ribavirin and monitoring of its plasma concentration in chronic hepatitis C infection. J Clin Exp Hepatol. 2012;2(1):42-54doi: 10.1016/S0973-6883(12)60090-5.
Naik, G. S., & Tyagi, M. G. (2012). A pharmacological profile of ribavirin and monitoring of its plasma concentration in chronic hepatitis C infection. Journal of clinical and experimental hepatology, 2(1), 42-54. https://doi.org/10.1016/S0973-6883(12)60090-5
Naik, Girish S, and Tyagi, Manoj G. "A pharmacological profile of ribavirin and monitoring of its plasma concentration in chronic hepatitis C infection." Journal of clinical and experimental hepatology vol. 2,1 (2012): 42-54. doi: https://doi.org/10.1016/S0973-6883(12)60090-5
Naik GS, Tyagi MG. A pharmacological profile of ribavirin and monitoring of its plasma concentration in chronic hepatitis C infection. J Clin Exp Hepatol. 2012 Mar;2(1):42-54. doi: 10.1016/S0973-6883(12)60090-5. Epub 2012 Apr 12. PMID: 25755405; PMCID: PMC3940409.
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J Clin Exp Hepatol. 2012 Mar;2(1):42-54. doi: 10.1016/S0973-6883(12)60090-5. Epub 2012 Apr 12.

A pharmacological profile of ribavirin and monitoring of its plasma concentration in chronic hepatitis C infection.

Journal of clinical and experimental hepatology

Girish S Naik, Manoj G Tyagi

Affiliations

  1. Department of Pharmacology and Clinical Pharmacology, Christian Medical College, Vellore - 632002, Tamil Nadu, India.

PMID: 25755405 PMCID: PMC3940409 DOI: 10.1016/S0973-6883(12)60090-5

Abstract

Chronic hepatitis C (CHC) infection, usually an asymptomatic infection, has long-term serious complications such as cirrhosis, hepatocellular carcinoma, and end-stage liver disease requiring liver transplantation (LT). Several novel drugs against hepatitis C which form part of 'specifically targeted antiviral therapy for hepatitis C' (STAT-C) have been developed. These include NS3/4A protease inhibitors telaprevir, boceprevir, and nucleoside/non-nucleoside polymerase inhibitors (NS5A) which hold promise for future therapy. Despite the development of new anti-hepatitis C virus (HCV) drugs, ribavirin (RBV) remains the single most important drug to prevent relapse and is frequently included among newer regimens being developed with novel small molecule anti-HCV drugs. The current approved treatment is a combination therapy of once weekly subcutaneous pegylated-interferon (PEG-IFN)-α plus body-weight-based oral RBV regimen. The most significant dose-dependent side effect of RBV is hemolytic anemia warranting dose reduction or discontinuation in severe cases compromising sustained virological response (SVR). Monitoring RBV plasma concentration has been challenging due to its peculiar pharmacokinetics and has been done to predict both efficacy and toxicity. Herein, we review the pharmacological profile of RBV and the monitoring of its plasma concentration, monitoring in renal impairment, post-LT, and human immunodeficiency virus (HIV)-HCV co-infection in patients being treated with combination therapy of PEG-IFN-α and RBV.

Keywords: ADSS, adenylosuccinate synthetase; ATP, adenosine-5′-triphosphate; AUC, area under concentration curve; BMD, bone mineral density; Css, concentration at steady-state; Ctrough, trough concentration; DAAs, directly acting antiviral agents; EPO, erythropoietin; EVR, early virological response; FDA, Food and Drug Administration; GTP, guanosine-5′-triphosphate; HCV; HCV, hepatitis C virus; HIV, human immunodeficiency virus; HPLC, high-performance liquid chromatography; Hb, hemoglobin; IFN, interferon; IMPDH, inosine-5′-monophosphate dehydrogenase; ITPA, inosine triphosphate pyro-phosphatase; PEG-IFN, pegylated-interferon; PSH, protein sulfhydryl; RBC, red blood cell; RBV, ribavirin; RNA, ribonucleic acid; RSV, respiratory syncytial virus; RVR, rapid virological response; STAT-C, specifically targeted therapy for hepatitis C; SVR, sustained virological response; TDM; TDM, therapeutic drug monitoring; plasma concentration; ribavirin

References

  1. Cell Mol Life Sci. 2006 Apr;63(7-8):832-42 - PubMed
  2. Hepatology. 2005 Feb;41(2):275-9 - PubMed
  3. Transplantation. 2002 Jan 15;73(1):56-63 - PubMed
  4. Nature. 2004 Dec 16;432(7019):922-4 - PubMed
  5. Curr Hepat Rep. 2011 Mar;10(1):33-40 - PubMed
  6. Ann Hepatol. 2009 Oct-Dec;8(4):316-24 - PubMed
  7. N Engl J Med. 1996 Mar 28;334(13):815-20 - PubMed
  8. Saudi J Gastroenterol. 2011 Jul-Aug;17(4):241-4 - PubMed
  9. N Engl J Med. 1998 Nov 19;339(21):1485-92 - PubMed
  10. J Gastroenterol. 2004 Jul;39(7):668-73 - PubMed
  11. Transplantation. 2002 Aug 27;74(4):427-37 - PubMed
  12. Clin Exp Med. 2005 Dec;5(4):190-5 - PubMed
  13. J Hepatol. 2009 Feb;50(2):402-11 - PubMed
  14. J Hepatol. 2001 Jun;34(6):911-6 - PubMed
  15. Br J Clin Pharmacol. 2006 Dec;62(6):710-4 - PubMed
  16. Gastroenterology. 2002 Dec;123(6):2082-99 - PubMed
  17. Drug Metab Pharmacokinet. 2004 Dec;19(6):438-43 - PubMed
  18. Hepatology. 2008 May;47(5):1453-61 - PubMed
  19. Lancet. 2001 Sep 22;358(9286):958-65 - PubMed
  20. Int J Artif Organs. 2008 Apr;31(4):295-302 - PubMed
  21. Intervirology. 2005;48(2-3):138-44 - PubMed
  22. Prog Drug Res. 2002;59:41-69 - PubMed
  23. J Chromatogr B Analyt Technol Biomed Life Sci. 2006 Feb 17;832(1):17-23 - PubMed
  24. Kidney Int Suppl. 2008 Apr;(109):S1-99 - PubMed
  25. Hepatology. 2002 Nov;36(5 Suppl 1):S237-44 - PubMed
  26. J Med Virol. 2008 Sep;80(9):1523-9 - PubMed
  27. J Hepatol. 2007 Jul;47(1):23-30 - PubMed
  28. JAMA. 2003 May 14;289(18):2413-7 - PubMed
  29. Hepatol Res. 2006 Jan;34(1):23-7 - PubMed
  30. Liver Int. 2006 Nov;26(9):1079-86 - PubMed
  31. Br J Clin Pharmacol. 2003 Apr;55(4):360-7 - PubMed
  32. Antiviral Res. 1992 Aug;19(2):139-47 - PubMed
  33. N Engl J Med. 2009 Apr 30;360(18):1839-50 - PubMed
  34. J Gastroenterol Hepatol. 2012 Apr;27(4):823-31 - PubMed
  35. Indian J Med Res. 2004 Apr;119(4):145-8 - PubMed
  36. Eur J Clin Pharmacol. 2012 Apr;68(4):415-8 - PubMed
  37. Lancet. 2010 Aug 28;376(9742):705-16 - PubMed
  38. J Viral Hepat. 2004 Jan;11(1):84-7 - PubMed
  39. J Acquir Immune Defic Syndr. 2005 Aug 1;39(4):401-5 - PubMed
  40. Lancet Infect Dis. 2005 Sep;5(9):558-67 - PubMed
  41. Liver Int. 2011 Jul;31 Suppl 2:61-80 - PubMed
  42. Transplant Proc. 2005 Sep;37(7):3190-6 - PubMed
  43. J Hepatol. 2007 May;46(5):768-74 - PubMed
  44. Nephrol Dial Transplant. 2008 Feb;23 (2):721-5 - PubMed
  45. J Viral Hepat. 2011 Apr;18(4):245-51 - PubMed
  46. Gastroenterology. 2003 May;124(6):1711-9 - PubMed
  47. Gut Liver. 2011 Dec;5(4):406-17 - PubMed
  48. J Clin Gastroenterol. 2012 Apr;46(4):328-33 - PubMed
  49. Gastroenterology. 2011 Apr;140(4):1314-21 - PubMed
  50. Clin Pharmacol Ther. 2005 Oct;78(4):422-32 - PubMed
  51. Ther Drug Monit. 2010 Apr;32(2):237-41 - PubMed
  52. Biophys Chem. 2010 Mar;147(1-2):59-65 - PubMed
  53. Transplantation. 2004 Sep 15;78(5):745-50 - PubMed
  54. J Antimicrob Chemother. 2008 Apr;61(4):919-24 - PubMed
  55. Liver Int. 2009 Jan;29 Suppl 1:74-81 - PubMed
  56. Pharmacology. 2006;76(3):136-40 - PubMed
  57. Ther Drug Monit. 2004 Feb;26(1):9-15 - PubMed
  58. Antivir Ther. 2010;15(5):687-95 - PubMed
  59. N Engl J Med. 2002 Sep 26;347(13):975-82 - PubMed
  60. Antimicrob Agents Chemother. 2010 Apr;54(4):1647-9 - PubMed
  61. Antivir Ther. 2007;12 (8):1217-23 - PubMed
  62. Am J Gastroenterol. 2008 Aug;103(8):1981-8 - PubMed
  63. Antivir Ther. 2011;16(8):1317-26 - PubMed
  64. Eur J Med Res. 2011 Jul 25;16(7):303-14 - PubMed
  65. Aliment Pharmacol Ther. 2011 Aug;34(4):454-61 - PubMed
  66. Eur J Pharmacol. 2007 Feb 14;557(1):1-8 - PubMed
  67. Antivir Ther. 2008;13(4):607-11 - PubMed
  68. J Antimicrob Chemother. 2008 Dec;62(6):1174-80 - PubMed
  69. Ther Drug Monit. 2007 Dec;29(6):802-6 - PubMed
  70. N Engl J Med. 2010 Apr 8;362(14 ):1292-303 - PubMed
  71. Cochrane Database Syst Rev. 2009 Oct 07;(4):CD005527 - PubMed
  72. Antimicrob Agents Chemother. 1999 Oct;43(10):2451-6 - PubMed
  73. Hepatology. 2004 May;39(5):1248-55 - PubMed
  74. Transplantation. 1995 May 27;59(10):1426-31 - PubMed
  75. Antivir Ther. 2011;16(5):695-704 - PubMed
  76. Ther Drug Monit. 2011 Feb;33(1):40-4 - PubMed
  77. Ann Hepatol. 2010 Apr-Jun;9(2):150-5 - PubMed
  78. J Hepatol. 2000 Nov;33(5):812-7 - PubMed
  79. J Virol. 2005 Feb;79(3):1943-7 - PubMed
  80. J Viral Hepat. 2006 Aug;13(8):538-43 - PubMed
  81. Hepatology. 2000 Apr;31(4):997-1004 - PubMed
  82. Ann Intern Med. 2006 May 16;144(10):705-14 - PubMed
  83. J Clin Microbiol. 2006 Oct;44(10 ):3562-8 - PubMed

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