Do Acid-Reducing Agents Reduce Efficacy of Direct-Acting Anti-HCV Drugs?

Acid-reducing agents (ARAs), including proton-pump inhibitors (PPIs), can potentially decrease the bioavailability of concomitant oral medications. Although package inserts of direct-acting antiviral agents for treatment of hepatitis C virus (HCV) infection contain cautions against concomitant use of ARAs, the effect of such use is poorly studied.

In a secondary analysis of data from six phase III trials of ombitasvir, ritonavir-boosted paritaprevir, and dasabuvir with or without ribavirin, researchers compared treatment success at 12 weeks after therapy between ARA users and nonusers.

Of 2035 patients, 410 (20%) used concomitant ARAs, of whom 75% were taking a PPI. Treatment success rates were high across all ARA use groups (any ARA use, 96%…