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Τετάρτη 3 Φεβρουαρίου 2021

Deinduction of P‐glycoprotein resulting in delayed viral response during hepatitis C treatment

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Deinduction of P‐glycoprotein resulting in delayed viral response during hepatitis C treatment

Drug‐drug interactions can involve induction of cell membrane transporters. Deinduction refers to the time course for enzymes or drug transporters to return to normal activity and can be delayed beyond the time required for clearance of the inducing agent. Clinicians should consider deinduction when starting and stopping medications involving strong inducers.


Abstract

What is known and objective

Drug‐drug interactions can involve inhibition or induction of cell membrane transporters. Deinduction occurs after an inducing agent is stopped.

Case summary

This case describes suspected P‐glycoprotein (P‐gp) deinduction by carbamazepine resulting in a slow viral response during treatment of chronic hepatitis C virus (HCV) infection. Evidence of deinduction occurred beyond clearance of carbamazepine and resulted in extension of HCV treatment.

What is new

The understanding of the role P‐gp transport plays in drug elimination is relatively new and evidence of P‐gp deinduction is variable.

Conclusion

Clinicians should consider deinduction when starting and stopping medications involving strong inducers of P‐gp transport proteins.

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