RGD Reference Report - Modeling Ribavirin-Induced Anemia in Patients with Chronic Hepatitis C Virus. - Rat Genome Database

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Modeling Ribavirin-Induced Anemia in Patients with Chronic Hepatitis C Virus.

Authors: Wu, LS  Jimmerson, LC  MacBrayne, CE  Kiser, JJ  D'Argenio, DZ 
Citation: Wu LS, etal., CPT Pharmacometrics Syst Pharmacol. 2016 Feb;5(2):65-73. doi: 10.1002/psp4.12058. Epub 2016 Feb 2.
RGD ID: 11528554
Pubmed: PMID:26933517   (View Abstract at PubMed)
PMCID: PMC4761234   (View Article at PubMed Central)
DOI: DOI:10.1002/psp4.12058   (Journal Full-text)

Ribavirin remains an important component of hepatitis C treatment in certain clinical scenarios, but it causes hemolytic anemia. A quantitative understanding of the ribavirin exposure-anemia relationship is important in dose individualization/optimization. We developed a model relating ribavirin triphosphate (RTP) exposure in red blood cells (RBCs), RBC lifespan, feedback regulation of RBC production when anemia occurs, and the resulting hemoglobin decline. Inosine triphosphatase (ITPA) and interleukin 28B (IL28B) genetics were found to be significant covariates. Clinical trial simulations predicted that anemia is least severe in IL28B non-CC (rs12979860, CT or TT), ITPA variant subjects, followed by IL28B non-CC, ITPA wild-type, IL28B CC, ITPA variant, and IL28B CC, ITPA wild-type subjects (most severe). Reducing the ribavirin dose from 1,200/1,000 mg to 800/600 mg could reduce the proportions of grade 2 anemia by about half. The resulting model framework will aid the development of dosing strategies that minimize the incidence of anemia in treatment regimens that include ribavirin.

RGD Manual Disease Annotations    Click to see Annotation Detail View
TermQualifierEvidenceWithReferenceNotesSourceOriginal Reference(s)
Drug-induced Anemia severityIAGP 11528554associated with Hepatitis C more ...RGD 
Drug-induced Anemia severityIAGP 11528554associated with Hepatitis C more ...RGD 
Drug-induced Anemia severityISOIFNL3 (Homo sapiens)11528554; 11528554associated with Hepatitis C more ...RGD 

Objects Annotated

Genes (Rattus norvegicus)
Ifnl3  (interferon, lambda 3)

Genes (Mus musculus)
Ifnl2  (interferon lambda 2)

Genes (Homo sapiens)
IFNL3  (interferon lambda 3)
IFNL4  (interferon lambda 4 (gene/pseudogene))


Additional Information