Author(s):
|
Vlerken, L.G. Van; Lieveld, F.I.; Meer, S. van; Koek, G.H.; Nieuwkerk, K.M. van; Friederich, P.; Arends, J.E.; Siersema, P.D.;
Burger, D.M.
; Erpecum, K.J. van
|
Subject:
|
Radboudumc 14: Tumours of the digestive tract RIHS: Radboud Institute for Health Sciences Radboudumc 4: lnfectious Diseases and Global Health RIHS: Radboud Institute for Health Sciences |
Organization:
|
Gastroenterology Clinical Pharmacy |
Journal title:
|
Clinics and Research in Hepatology and Gastroenterology
|
Abstract:
|
BACKGROUND AND OBJECTIVE: Adherence is essential in antiviral therapy for chronic hepatitis C. We investigated the effect of real-time medication monitoring on adherence to ribavirin. METHODS: In this randomized controlled trial, patients in the intervention group received a medication dispenser that monitored ribavirin intake real-time during 24 weeks PEG-interferon/ribavirin+/-boceprevir or telaprevir. Patients in the control group received standard-of-care. Adherence was also measured by pill count. RESULTS: Seventy-two patients were assigned to either intervention (n=35) or control groups (n=37). Median adherence by pill count was 96% (range: 43%-100%) with 30 (94%) of patients exhibiting>/=80% adherence. Perfect adherence (i.e. 100%) was similar in intervention and control groups: 22 (85%) vs. 15 (75%) (P=0.47). Adherences by real-time medication monitoring and by pill count did not correlate (R=0.19, P=0.36). No predictors of poor adherence could be identified. Ribavirin trough levels after 8 weeks (median: 2.4 vs. 2.7mg/L, P=0.30) and 24 weeks (median: 3.0 vs. 3.0mg/L, P=0.69), and virological responses did not differ between intervention and control groups. CONCLUSIONS: Adherence to ribavirin during PEG-interferon containing therapy in chronic hepatitis C is high. Real-time medication monitoring did not influence adherence to ribavirin, plasma ribavirin levels or virological responses.
|