Gadoxetic Acid-Enhanced MR Imaging Predicts Simeprevir-Induced Hyperbilirubinemia During Hepatitis C Virus Treatment: A Pilot Study
Gadoxetic Acid-Enhanced MR Imaging Predicts Simeprevir-Induced Hyperbilirubinemia During Hepatitis C Virus Treatment: A Pilot Study
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DOI：
10.1002/jcph.811
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发表时间：
2017-03-01
影响因子：
2.9
通讯作者：
Watanabe, Sumio
中科院分区：
文献类型：
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作者：
Okubo, Hironao;Kitamura, Tsuneo;Watanabe, Sumio
西莫普韦是有机阴离子转运多肽（oats）的底物，oats可转运胆红素。高胆红素血症是慢性丙型肝炎患者西莫普韦联合聚乙二醇化干扰素和利巴韦林治疗期间报道的不良事件。由于加多糖酸也是oops的底物，预处理加多糖酸增强磁共振成像（MRI）可以预测治疗期间的高胆红素血症。因此，这项前瞻性研究评估了连续11例慢性丙型肝炎患者，这些患者在接受西莫普韦加聚乙二醇干扰素和利巴韦林治疗12周之前接受了加多西酸增强MRI，随后接受了聚乙二醇干扰素和利巴韦林治疗12周。治疗前评估对比增强指数（CEI），即肝胆期肝实质增强指数。在给药后7天测定西莫普韦的血浆谷浓度（Ctrough），并在整个治疗过程中测定血清胆红素浓度。6例（55%）患者在治疗期间出现高胆红素血症（>= 1.6 mg/dL）。高胆红素血症患者的Ctrough显著高于非高胆红素血症患者（P = 0.009）， CEI与Ctrough呈强负相关(r = -0.911， P
Simeprevir is a substrate for organic anion-transporting polypeptides (OATPs) that transport bilirubin. Hyperbilirubinemia is an adverse event reported during treatment of chronic hepatitis C patients with simeprevir plus pegylated interferon and ribavirin. Because gadoxetic acid is also a substrate of OATPs, pretreatment gadoxetic acid-enhanced magnetic resonance imaging (MRI) may predict hyperbilirubinemia during treatment. This prospective study therefore evaluated 11 consecutive patients with chronic hepatitis C who underwent gadoxetic acid-enhanced MRI prior to treatment with simeprevir plus pegylated interferon and ribavirin for 12 weeks, followed by pegylated interferon and ribavirin for an additional 12 weeks. Their contrast enhancement index (CEI), an index of liver parenchymal enhancement during the hepatobiliary phase, was assessed before treatment. Plasma trough concentrations (Ctrough) of simeprevir were determined 7 days after its administration, and serum bilirubin concentrations were measured throughout the course of treatment. Six patients (55%) developed hyperbilirubinemia (>= 1.6 mg/dL) during treatment. Ctrough was significantly higher in patients with than without hyperbilirubinemia (P =.009), with a strong inverse relationship between CEI and Ctrough (r = -0.911, P