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Drug-Drug Interactions Between DAAs and Anticoagulants or Antiplatelets: A Position Paper of the Italian

Elisabetta Tombolini1, Alessandro Squizzato2,3, Gian Marco Podda4

  • 1Emergency Medicine and Thrombosis and Haemostasis Center, ASST Sette Laghi, Varese, Italy.

Liver International : Official Journal of the International Association for the Study of the Liver
|December 30, 2024
PubMed

Insights

Direct-acting antiviral agents (DAAs) offer new hope for hepatitis C virus (HCV) infection, but drug-drug interactions (DDIs) with blood thinners are a concern. This study provides guidance for managing these complex cases.

Area of Science:

  • Hepatology
  • Pharmacology
  • Cardiology

Background:

  • Chronic hepatitis C virus (HCV) infection management has evolved with direct-acting antiviral agents (DAAs).
  • HCV infection is linked to increased cardiovascular risk.
  • DAAs have complex metabolic pathways, raising concerns for drug-drug interactions (DDIs).

Purpose of the Study:

  • To provide guidance on managing DDIs between DAAs and antiplatelet or anticoagulant drugs.
  • To address the clinical challenge of co-prescribing DAAs with antithrombotic agents.

Main Methods:

  • Review of pharmacodynamic and pharmacokinetic data.
  • Integration of clinical experience in hemostasis and thrombosis.
  • Evidence-based recommendations for managing DDIs.

Main Results:

  • Identification of potential DDIs between DAAs and antiplatelet/anticoagulant therapies.
  • Development of practical strategies for managing these interactions.
  • Emphasis on individualized patient management.

Conclusions:

  • Managing DDIs is crucial for safe and effective HCV treatment with DAAs.
  • Clinical experience and pharmacokinetic/pharmacodynamic data are key to managing these interactions.
  • Further research may be needed to fully elucidate DDI profiles.

Keywords:
DOACanticoagulantsantiviral agentsdrug interactionshepatitis C

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