Limits...
Colitis Following Initiation of Sofosbuvir and Simeprevir for Genotype 1 Hepatitis C.

Sarkar S, Mitchell KA, Lim JK, Oikonomou I, Jakab S - ACG Case Rep J (2015)

Bottom Line: Both drugs have been well-tolerated, with diarrhea noted in 6% cases with sofosbuvir, 16% with sofosbuvir plus simeprevir, and 0% with simeprevir.No prior reports exist of colitis secondary to either drug or their combination.Colonoscopy and biopsy confirmed pancolitis, which responded to mesalamine and completion of sofosbuvir/simeprevir.

View Article: PubMed Central - PubMed

Affiliation: Section of Digestive Diseases, Yale University School of Medicine, New Haven, CT.

ABSTRACT
Sofosbuvir and simeprevir are used for the treatment of chronic hepatitis C (HCV) genotype 1. Both drugs have been well-tolerated, with diarrhea noted in 6% cases with sofosbuvir, 16% with sofosbuvir plus simeprevir, and 0% with simeprevir. No prior reports exist of colitis secondary to either drug or their combination. We report a patient with no prior history of inflammatory bowel disease who developed significant bloody diarrhea within 2 weeks of sofosbuvir/simeprevir initiation. Colonoscopy and biopsy confirmed pancolitis, which responded to mesalamine and completion of sofosbuvir/simeprevir.

No MeSH data available.


Related in: MedlinePlus

Endoscopic and microscopic images of the colon 28 weeks after completion of sofosbuvir/simeprevir. (A, B) Normal mucosa. (C) Reactive colonic mucosa with minimal inflammatory changes.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4612757&req=5

Figure 3: Endoscopic and microscopic images of the colon 28 weeks after completion of sofosbuvir/simeprevir. (A, B) Normal mucosa. (C) Reactive colonic mucosa with minimal inflammatory changes.

Mentions: Sofosbuvir/simeprevir was continued, but given persistent bloody diarrhea, he underwent colonoscopy at week 9 of therapy. This showed persistent, mild to moderate chronic colitis (Figure 2). Terminal ileum was unremarkable both endoscopically and histologically. On week 10 of therapy, he was initiated on 2.4 g mesalamine once daily, with resolution of his diarrhea over the following 2 weeks. He remained clinically asymptomatic on mesalamine, and achieved SVR. Seven months after completion of sofosbuvir/simeprevir treatment, but with the patient still taking mesalamine, repeat colonoscopy demonstrated normal mucosa macroscopically with minimal inflammatory changes on colonic mucosa and focal minimal non-specific ileitis (Figure 3). Serologic and genetic testing was performed using the PROMETHEUS® IBD sgi Diagnostic™ test (Prometheus Laboratories, Inc., San Diego, CA). The results revealed a possible predisposition to IBD, specifically Crohn's disease.


Colitis Following Initiation of Sofosbuvir and Simeprevir for Genotype 1 Hepatitis C.

Sarkar S, Mitchell KA, Lim JK, Oikonomou I, Jakab S - ACG Case Rep J (2015)

Endoscopic and microscopic images of the colon 28 weeks after completion of sofosbuvir/simeprevir. (A, B) Normal mucosa. (C) Reactive colonic mucosa with minimal inflammatory changes.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4612757&req=5

Figure 3: Endoscopic and microscopic images of the colon 28 weeks after completion of sofosbuvir/simeprevir. (A, B) Normal mucosa. (C) Reactive colonic mucosa with minimal inflammatory changes.
Mentions: Sofosbuvir/simeprevir was continued, but given persistent bloody diarrhea, he underwent colonoscopy at week 9 of therapy. This showed persistent, mild to moderate chronic colitis (Figure 2). Terminal ileum was unremarkable both endoscopically and histologically. On week 10 of therapy, he was initiated on 2.4 g mesalamine once daily, with resolution of his diarrhea over the following 2 weeks. He remained clinically asymptomatic on mesalamine, and achieved SVR. Seven months after completion of sofosbuvir/simeprevir treatment, but with the patient still taking mesalamine, repeat colonoscopy demonstrated normal mucosa macroscopically with minimal inflammatory changes on colonic mucosa and focal minimal non-specific ileitis (Figure 3). Serologic and genetic testing was performed using the PROMETHEUS® IBD sgi Diagnostic™ test (Prometheus Laboratories, Inc., San Diego, CA). The results revealed a possible predisposition to IBD, specifically Crohn's disease.

Bottom Line: Both drugs have been well-tolerated, with diarrhea noted in 6% cases with sofosbuvir, 16% with sofosbuvir plus simeprevir, and 0% with simeprevir.No prior reports exist of colitis secondary to either drug or their combination.Colonoscopy and biopsy confirmed pancolitis, which responded to mesalamine and completion of sofosbuvir/simeprevir.

View Article: PubMed Central - PubMed

Affiliation: Section of Digestive Diseases, Yale University School of Medicine, New Haven, CT.

ABSTRACT
Sofosbuvir and simeprevir are used for the treatment of chronic hepatitis C (HCV) genotype 1. Both drugs have been well-tolerated, with diarrhea noted in 6% cases with sofosbuvir, 16% with sofosbuvir plus simeprevir, and 0% with simeprevir. No prior reports exist of colitis secondary to either drug or their combination. We report a patient with no prior history of inflammatory bowel disease who developed significant bloody diarrhea within 2 weeks of sofosbuvir/simeprevir initiation. Colonoscopy and biopsy confirmed pancolitis, which responded to mesalamine and completion of sofosbuvir/simeprevir.

No MeSH data available.


Related in: MedlinePlus