Carrascosa R, Montes-Torres A, Llamas-Velasco M, Gordillo C, García-Buey L, Sánchez-Pérez J

Language: Spanish
References: 16
Page: 104-109
PDF size: 296.74 Kb.

ABSTRACT

Introduction: Telaprevir treatment of chronic hepatitis C has increased cutaneous side-effects. In clinical practice, there is not a consensus on how to treat these skin reactions and when to interrupt the antiviral treatment. Material and methods: Prospective cohort study with a total of 60 patients who started treatment with triple antiviral therapy with pegylated interferon, ribavirin and telaprevir in Hospital Universitario La Princesa between February 2012 and June 2014, with subsequent six-months follow-up after having completed the antiviral treatment. Results: Eight patients developed pruritus without skin lesions and were treated with oral antihistamines. 21 patients developed a mild to moderate cutaneous drug reaction and were treated with oral antihistamines and high-potency topical corticosteroids. In eight patients the cutaneous drug reaction was severe and their management was variable: one patient discontinued telaprevir and received systemic corticosteroids; three discontinued telaprevir and were treated with high-potency topical corticosteroids and oral antihistamines; two had to interrupt all antiviral drugs and received systemic corticosteroids, and in the remaining two, the interruption of any antiviral drug was not necessary due to the use of very high-potency topical corticosteroids. Discussion: An intensive management with oral antihistamines and very high-potency topical corticosteroids, together with a closely dermatological follow-up, could be enough to manage most severe cutaneous drug reactions related to telaprevir and it could avoid premature interruption of the antiviral therapy. Conclusions: We would like to stress the importance of close collaboration between dermatologists and hepatologists in the management of cutaneous side-effects during TPV triple therapy.

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