Zhou Y, Xie W, Zheng C, et al. - In rare cases of chronic hepatitis C virus (HCV), direct-acting antiviral agents (DAAs) result in induction of hypoglycemia which is a potentially life-threatening adverse reaction. Herein, the hypoglycemic safety signal for DAAs has been examined.

• Researchers analyzed reports to the US Food and Drug Administration Adverse Event Reporting System (FAERS).

• In HCV infection with diabetes patients, the cumulative frequency of hypoglycemic ADRs was 21.85/1,000 vs 13.50/1,000 for reports involving DAAs vs other medications, respectively.

• There appeared a nearly double increased reporting odds for hypoglycemia for DAAs as a class drug.

• In DAAs subgroup analysis, correlation of only telaprevir and elbasvir/grazoprevir was observed with increased reporting risk of hypoglycemia during corresponding marketing period; DAAs, in combination with insulins and sulfonylureas, were linked with elevated reporting risk for hypoglycemia, but there appeared no significance of concomitant biguanides, dipeptidyl peptidase IV (DPP-4) inhibitors or glucagon-like peptide-1 receptor agonists (GLP-1RAs).

• These findings overall support practicing caution about hypoglycemic risk relating to the use of DAAs.

• Increased hypoglycemia reporting risk was observed in correlation with receiving treatment with DAAs and antidabetic agents (especially insulins and sulfonylureas).

• Researchers recommend physicians and pharmacists to be aware of this risk when administering DAAs for patients suffering from diabetes, advanced age or liver decompensation.