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Page 1: Z · Amlodipin t & # & , !6 Ë -/ W(/(6 + + Amlodipine Amlodipine is a substrate of CYP3A4 and co -administration increased amlodipine AUC by 2.6-fold. Caution is warranted. Consider
Page 2: Z · Amlodipin t & # & , !6 Ë -/ W(/(6 + + Amlodipine Amlodipine is a substrate of CYP3A4 and co -administration increased amlodipine AUC by 2.6-fold. Caution is warranted. Consider

Д. Дук ва, И. Ива ва, И. К цев

К

„Лю о ен еликсир“

Page 3: Z · Amlodipin t & # & , !6 Ë -/ W(/(6 + + Amlodipine Amlodipine is a substrate of CYP3A4 and co -administration increased amlodipine AUC by 2.6-fold. Caution is warranted. Consider

а А Е И

AMETHYST Cohort

И 8%

Ива и и 19%

А 11%

ия 26%

а 16%

а а 13%

[CATEGORY NAME]

5%

8

N = 62

3%

Page 4: Z · Amlodipin t & # & , !6 Ë -/ W(/(6 + + Amlodipine Amlodipine is a substrate of CYP3A4 and co -administration increased amlodipine AUC by 2.6-fold. Caution is warranted. Consider

Ха акте т к е ултат (N = 62)

т, од 57 (18-76)

к пол, n (%) 34 (55%)

о , n (%) 45 (73%)

Child Pugh A, n (%) 43 (96%)

Child Pugh B, n (%) 2 (4%)

MELD score 10 (6 -16)

о е л (%) 73%

т (%) 9%

HCV RNA, IU/ml 2 566 311 (2 740 - 27 000 000)

/ b/ е е те у т п (%) 1.6% / 92% / 6.4%

еу пе о п ед е т о ле е е, n (%)

41 (66%)

а А Е И

AMETHYST Cohort

Page 5: Z · Amlodipin t & # & , !6 Ë -/ W(/(6 + + Amlodipine Amlodipine is a substrate of CYP3A4 and co -administration increased amlodipine AUC by 2.6-fold. Caution is warranted. Consider

[VALU

E]/61

([PE…

а А Е И

AMETHYST Cohort

Page 6: Z · Amlodipin t & # & , !6 Ë -/ W(/(6 + + Amlodipine Amlodipine is a substrate of CYP3A4 and co -administration increased amlodipine AUC by 2.6-fold. Caution is warranted. Consider

Ха акте т к е ултат (N = 31)

т, од 55 (35 – 81)

≥ од , n (%) 6 (19.3%)

к пол, n (%) 14 (45.2%)

BMI, kg/m2 24.8 (17.1 – 36.7)

о , n (%) 12 (40.0%)

Child Pugh A, n (%) 11 (91.7%)

Child Pugh B, n (%) 1 (8.3%)

MELD score 8 (6-12)

о е л , n (%) 5/16 (31.3%)

I – II т. , n (%) 5 (100%)

III - IV т. , n (%) 0

т, n (%) 1/30 (3.33%)

Page 7: Z · Amlodipin t & # & , !6 Ë -/ W(/(6 + + Amlodipine Amlodipine is a substrate of CYP3A4 and co -administration increased amlodipine AUC by 2.6-fold. Caution is warranted. Consider

Ха акте т к е ултат (N = 31)

т д о

F0-F2, n (%) 6/21 (28.5%)

F3-F4, n (%) 15/21 (71.4%)

FibroScan

ед те л) 12 (5.6 – 44)

≥ 12.5 kPa, n (%) 5/11 (45.5%)

Page 8: Z · Amlodipin t & # & , !6 Ë -/ W(/(6 + + Amlodipine Amlodipine is a substrate of CYP3A4 and co -administration increased amlodipine AUC by 2.6-fold. Caution is warranted. Consider

Ха акте т к е ултат (N = 31)

HCV е от п

+ b, n (%) 1 (3.3%)

1b, n (%) 26 (86.6%)

е е те у т п), n (%) 2 (6.66%)

е от п 1 (3.3%)

HCV RNA, IU/ml 2 990 000 (2740 - 19 542 280)

HCV RNA ≥ л IU/ml, n (%) 7 (24.1%)

Page 9: Z · Amlodipin t & # & , !6 Ë -/ W(/(6 + + Amlodipine Amlodipine is a substrate of CYP3A4 and co -administration increased amlodipine AUC by 2.6-fold. Caution is warranted. Consider

Ха акте т к е ултат (N = 31)

елеку , n (%) 18 (60.0%)

Леку , n (%) 12 (40.0%)

1 п ед е т ку 8

п ед е т ку 2

п ед е т ку 2

ел п 4 (33.3%)

Non-response 8 (66.6%)

Page 10: Z · Amlodipin t & # & , !6 Ë -/ W(/(6 + + Amlodipine Amlodipine is a substrate of CYP3A4 and co -administration increased amlodipine AUC by 2.6-fold. Caution is warranted. Consider

10%

53%

27%

7%

10%

3%

3%

3%

3%

0% 10% 20% 30% 40% 50% 60%

е п д у оля я

К д кул

е д ет

е толо

е толо

ео д

п леп я

еп е о т о т о

е пол к то , I т

Page 11: Z · Amlodipin t & # & , !6 Ë -/ W(/(6 + + Amlodipine Amlodipine is a substrate of CYP3A4 and co -administration increased amlodipine AUC by 2.6-fold. Caution is warranted. Consider

27%

30%

7%

17%

0% 3%

7%

3% 3% 3% 0%

10%

20%

30%

0 1 2 3 4 5 6 7 8 9

% п

ет

о п д у ед к е т

54%

10%

9%

Page 12: Z · Amlodipin t & # & , !6 Ë -/ W(/(6 + + Amlodipine Amlodipine is a substrate of CYP3A4 and co -administration increased amlodipine AUC by 2.6-fold. Caution is warranted. Consider

6%

6%

6%

10%

10%

10%

10%

13%

13%

20%

20%

27%

27%

0% 10% 20% 30%

ACE то

ул

т о

еле е п еп т

т д е е

е о л т д ет

К л е т о т

у ет

оте е епто локе

ет локе

е те п я

Page 13: Z · Amlodipin t & # & , !6 Ë -/ W(/(6 + + Amlodipine Amlodipine is a substrate of CYP3A4 and co -administration increased amlodipine AUC by 2.6-fold. Caution is warranted. Consider

27% 73%

е п д у те п я

п д у те п я

е е о к т оде т я

оте л о оде т я

Ко т д

20%

46%

7%

Page 14: Z · Amlodipin t & # & , !6 Ë -/ W(/(6 + + Amlodipine Amlodipine is a substrate of CYP3A4 and co -administration increased amlodipine AUC by 2.6-fold. Caution is warranted. Consider

Н HCV RNA –95.0%

Н HCV RNA –

100%

Н

HCV RNA – 100%

Page 15: Z · Amlodipin t & # & , !6 Ë -/ W(/(6 + + Amlodipine Amlodipine is a substrate of CYP3A4 and co -administration increased amlodipine AUC by 2.6-fold. Caution is warranted. Consider

т е ект , оде до п еу т о я е ле е ето: 1

Че т т е ект ≥ % от п е т те : − Отп д ло т

− л о ол е

− е

− е е ото

SAE: 2 п е т

− Че од о е е лоп т я, еп , е док д т, епт е до л о т , п о е е

едо т т о т, пол о едо т т о т - exitus 05/2015

− е о я

Page 16: Z · Amlodipin t & # & , !6 Ë -/ W(/(6 + + Amlodipine Amlodipine is a substrate of CYP3A4 and co -administration increased amlodipine AUC by 2.6-fold. Caution is warranted. Consider

е , 7 од

е е о оло кт о т 10 по , о - / . .

HCV RNA – 3 686 046 IU/ml / 12.01.2015

е от п HCV

е ло 3 kg

о еде о ле е е:

. . – IFN/RBV од – е от о о

. 8 . – PegIFN/RBV – ел п

Page 17: Z · Amlodipin t & # & , !6 Ë -/ W(/(6 + + Amlodipine Amlodipine is a substrate of CYP3A4 and co -administration increased amlodipine AUC by 2.6-fold. Caution is warranted. Consider

д у оля я:

те л пе то я – ле е е Amlodipin 5 mg д е о p.o.

пе де е я – п о е д ле ото

пле екто я лед т

е о о т о т о – п у д Rivotril

е т

FibroScan 21.2 kPa (= F4)

Page 18: Z · Amlodipin t & # & , !6 Ë -/ W(/(6 + + Amlodipine Amlodipine is a substrate of CYP3A4 and co -administration increased amlodipine AUC by 2.6-fold. Caution is warranted. Consider

Do not Coadminister Potential Interaction No Interaction Expected No Clear Data

OBV/PTV/r + DSV

Amlodipine

Clonazepam

Hidroxyzine

OBV/PTV/r + DSV

Page 19: Z · Amlodipin t & # & , !6 Ë -/ W(/(6 + + Amlodipine Amlodipine is a substrate of CYP3A4 and co -administration increased amlodipine AUC by 2.6-fold. Caution is warranted. Consider

12.01.2015 WK 4 WK 8 FU WK12

ло ле е е

2 т л. ут

; 2 1 т л. 12

Ribavirin 2 + 0 + 3 т л. 12 .

Page 20: Z · Amlodipin t & # & , !6 Ë -/ W(/(6 + + Amlodipine Amlodipine is a substrate of CYP3A4 and co -administration increased amlodipine AUC by 2.6-fold. Caution is warranted. Consider

12.01.2015 WK 4 WK 8 FU WK12

ока ател 12.01.2015

е о ло , g/l 150

о о т , 9/l 308

К е т , µmol/l 40

О л у , µmol/l 19

л у , g/l 45

Л , IU/l 34

, IU/l 45

ол е те , IU/l 6952

INR 1.210

MELD 9

HCV RNA, IU/ml 3 686 046

Page 21: Z · Amlodipin t & # & , !6 Ë -/ W(/(6 + + Amlodipine Amlodipine is a substrate of CYP3A4 and co -administration increased amlodipine AUC by 2.6-fold. Caution is warranted. Consider

12.01.2015 WK 4 WK 8 FU WK12

оя пе е ото

Page 22: Z · Amlodipin t & # & , !6 Ë -/ W(/(6 + + Amlodipine Amlodipine is a substrate of CYP3A4 and co -administration increased amlodipine AUC by 2.6-fold. Caution is warranted. Consider

12.01.2015 WK 4 WK 8 FU WK12

е от е

д о

Че од о о

к еде

е о т

де едо т т о т

Л еде

ле от о о

Page 23: Z · Amlodipin t & # & , !6 Ë -/ W(/(6 + + Amlodipine Amlodipine is a substrate of CYP3A4 and co -administration increased amlodipine AUC by 2.6-fold. Caution is warranted. Consider

12.01.2015 WK 4 WK 8 FU WK12

ока ател 12.01.2015

е о ло , g/l 150

о о т , 9/l 308

К е т , µmol/l 40

О л у , µmol/l 19

л у , g/l 45

Л , IU/l 34

, IU/l 45

ол е те , IU/l 6952

INR 1.210

MELD 9

HCV RNA, IU/ml 3 686 046

02.2015

155

390

18

18

33

е е отк

03.2015

133

289

19

19

28

е е отк

Page 24: Z · Amlodipin t & # & , !6 Ë -/ W(/(6 + + Amlodipine Amlodipine is a substrate of CYP3A4 and co -administration increased amlodipine AUC by 2.6-fold. Caution is warranted. Consider

12.01.2015 WK 4 WK 8 FU WK12

Amlodipinе –

е ел е к

Че т : ото

Page 25: Z · Amlodipin t & # & , !6 Ë -/ W(/(6 + + Amlodipine Amlodipine is a substrate of CYP3A4 and co -administration increased amlodipine AUC by 2.6-fold. Caution is warranted. Consider

+ + Amlodipine

Amlodipine is a substrate of CYP3A4

and co-administration increased

amlodipine AUC by 2.6-fold. Caution

is warranted. Consider a dose

reduction for amlodipine (a dose

reduction of 50% is recommended

in the European SPC).

Clinical monitoring of patients is

recommended.

Page 26: Z · Amlodipin t & # & , !6 Ë -/ W(/(6 + + Amlodipine Amlodipine is a substrate of CYP3A4 and co -administration increased amlodipine AUC by 2.6-fold. Caution is warranted. Consider

12.01.2015 WK 4 WK 8 FU WK12

ока ател 12.01.2015 02.2015 03.2015

е о ло , g/l 150 155 133

о о т , 9/l 308 390 289

К е т , µmol/l 40

О л у , µmol/l 19 18 19

л у , g/l 45

Л , IU/l 34 18 19

, IU/l 45 33 28

ол е те , IU/l 6952

INR 1.210

MELD 9

HCV RNA, IU/ml 3 686 046 е е отк е е отк

02.09.2015

153

298

43

11

43

29

19

6553

1.010

7

е е отк

Page 27: Z · Amlodipin t & # & , !6 Ë -/ W(/(6 + + Amlodipine Amlodipine is a substrate of CYP3A4 and co -administration increased amlodipine AUC by 2.6-fold. Caution is warranted. Consider

Ribavirin 12

HCV

GT1-

Page 28: Z · Amlodipin t & # & , !6 Ë -/ W(/(6 + + Amlodipine Amlodipine is a substrate of CYP3A4 and co -administration increased amlodipine AUC by 2.6-fold. Caution is warranted. Consider

С

,

,

Page 29: Z · Amlodipin t & # & , !6 Ë -/ W(/(6 + + Amlodipine Amlodipine is a substrate of CYP3A4 and co -administration increased amlodipine AUC by 2.6-fold. Caution is warranted. Consider