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Abstract Details
Elbasvir/grazoprevir administered for 12 weeks via Percutaneous Endoscopic Gastrostomy Tube Achieves Sustained Virologic Response: A Case Report and a Review of the Literature
Pharmacotherapy. 2021 May 2. doi: 10.1002/phar.2531. Online ahead of print.
Rajeev B Shah1, Katy L Garrett2, Amy L Brotherton3, Amanda J Noska4
Author information
1Division of Infectious Diseases, The Miriam Hospital, 164 Summit Avenue, Providence, 02906.
2Department of Pharmacy, Maine Medical Center, Portland.
3Division of Infectious Diseases, The Miriam Hospital, Providence, Rhode Island.
4Infectious Diseases, Essentia Health and St. Mary's Medical Center, Duluth.
Abstract
Enteral tubes are necessary for certain patients; however, medication absorption can be affected by this route of administration potentially resulting in decreased efficacy. All first-line treatments for Hepatitis C Virus (HCV) infections are only available as tablets and may have decreased absorption if administered via an enteral tube. This report describes the first case of a pegylated-interferon and ribavirin treatment-experienced patient who successfully achieved HCV cure after 12 weeks of elbasvir/grazoprevir administered via percutaneous gastrostomy tube. We further review the available pharmacokinetic and clinical literature regarding administration via enteral feeding tubes for all first-line direct acting antivirals (DAAs). The literature suggests that crushed administration can be considered for DAAs in patients with gastric access. However, caution should be exercised in patients with extragastric enteral tubes and in those with altered gastrointestinal tract anatomy.