Assessment of alteration in antiviral plasma concentration across dialysis days: computational and analytical study: Supplementary materials

Aim: Protein-bound uremic toxins (PBUTs) may displace drugs from the plasma proteins and render them
more liable to clearance. This study aims to investigate the possible interplay between PBUTs and directly
acting antivirals (DAAs). Methods: PBUT plasma protein binding was compared to those of paritaprevir
(PRT), ombitasivir (OMB) and ritonavir (RTV) in silico to assess the possible competitive displacement. The
three drugs were LC–MS/MS determined in seven patients across dialysis and non-dialysis days and results
were compared. Results & conclusion: Results showed that the PBUT exhibited a lower binding than
DAA reducing the liability of their competitive displacement. This was echoed by an unaltered plasma
concentration across dialysis days. Results may indicate that PBUT accumulation may have limited effect
on disposition of DAA.