High Prevalence of Comorbidities and Contraindicated Medications in HCV Patients in Japan

【Objectives】To determine the prevalence of comorbidities and drug-drug interactions (DDIs) in CHC patients in Japan.
【Methods】 Patients were identified using the ICD10 code for CHC in the Japanese database (04/2008-08/2014). Prescriptions were categorized as either red (contraindicated) or amber (additional monitoring/dose reduction required) for DDI potential with at least one currently licensed direct-acting antiviral (DAA).
【Results】92,294 patients were identified, average age was 68. 82％ of patients had one or more comorbidity; the number with ≧6 comorbidities increased with age from 2％ of patients aged 18-34 to 17％ for patients ≧75. The most common were hypertension (44％), chronic gastritis (33％) and gastro-oesophageal reflux disease (32％). 74％ were treated with amber DDIs and 26％ were on red. Polypharmacy increased with age, from 43％ for 18-34 to 82％ for ≧75 (amber) and from 13％ to 29％ for 18-34 year olds and ≧75 respectively (red). 81％ of treated patients had a potential DDI, increasing from 61％ for 18-34 years to 90％ for ≧75.
【Conclusions】We observed significant co-morbidity and co-prescribing with DDI potential in CHC patients in Japan. Hence, the high proportion of co-medications contraindicated to all DAA’s vs. only some suggests careful selection of the DAA regimen is required.