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The ARRIBA concept: adequate resorption of ribavirin.
- Source :
-
Antiviral therapy [Antivir Ther] 2015; Vol. 20 (5), pp. 515-20. Date of Electronic Publication: 2015 Jan 19. - Publication Year :
- 2015
-
Abstract
- Background: Adequate ribavirin exposure is essential for optimal sustained virological response (SVR) rates in chronic HCV treatment. It has been proposed that the area under the concentration-time curve up to 4 h after intake of ribavirin (AUC0-4 h) of the first weight-based ribavirin dose should be ≥1.755 mg•h/l to guarantee the highest chance of SVR. Our ARRIBA concept comprises a test dose of ribavirin to select the optimal starting dose to achieve adequate exposure. This study aims to evaluate whether adequate exposure can be achieved after dose advice based on the AUC0-4 h of a single weight-based ribavirin test dose.<br />Methods: (Formerly) HCV-infected subjects received a single weight-based ribavirin test dose (<75 kg: 400 mg; ≥75 kg: 600 mg) and the AUC0-4 h was calculated. If ribavirin AUC0-4 h was ≥1.755 mg•h/l, subjects received the same dose 4 weeks later; if the AUC0-4 h was <1.755 mg•h/l, an adjusted dose was administered. The ribavirin AUC0-4 h was recorded again. The primary outcome was the proportion of subjects with an AUC0-4 h ≥1.755 mg•h/l after the second dose.<br />Results: A total of 26 subjects were included. The geometric mean (95% CI) ribavirin AUC0-4 h was 1.67 (1.44-1.92) mg•h/l with 9 subjects (35%) reaching the target AUC on day 1. Thus, on day 29, 17 subjects (65%) received an adjusted dose. The geometric mean (95% CI) AUC0-4 h increased to 1.90 (1.62-2.21) mg•h/l and then 16 subjects (62%) had an AUC0-4 h ≥1.755 mg•h/l, which is significantly higher than day 1 (P<0.05).<br />Conclusions: Our ARRIBA concept of a ribavirin test dose, with dose adjustment if necessary, leads to an increased proportion of patients with an AUC≥1.755 mg•h/l compared to traditional weight-based ribavirin dosing.
- Subjects :
- Adult
Aged
Antiviral Agents therapeutic use
Coinfection
Dose-Response Relationship, Drug
Female
HIV Infections complications
Hepacivirus drug effects
Hepatitis C, Chronic complications
Humans
Male
Middle Aged
Prospective Studies
Ribavirin therapeutic use
Treatment Outcome
Viral Load drug effects
Young Adult
Antiviral Agents pharmacokinetics
Area Under Curve
Hepatitis C, Chronic drug therapy
Ribavirin pharmacokinetics
Subjects
Details
- Language :
- English
- ISSN :
- 2040-2058
- Volume :
- 20
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Antiviral therapy
- Publication Type :
- Academic Journal
- Accession number :
- 25599333
- Full Text :
- https://doi.org/10.3851/IMP2935