{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T23:39:23Z","timestamp":1777419563371,"version":"3.51.4"},"reference-count":87,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2009,11,17]],"date-time":"2009-11-17T00:00:00Z","timestamp":1258416000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ann Pharmacother"],"published-print":{"date-parts":[[2009,12]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To evaluate the utility of therapeutic drug monitoring (TDM) for ribavirin in chronic hepatitis C.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources:<\/jats:title>\n                    <jats:p>Literature searches were conducted through PubMed (1949\u2013June 2009), EMBASE (1980\u2013June 2009), BIOSIS Previews (1969\u2013June 2009), International Pharmaceutical Abstracts (1970\u2013June 2009), Google, and www.clinicaltrials.gov using the terms ribavirin, therapeutic monitoring, hepatitis C, and drug levels. In addition, pertinent reference citations from identified publications were reviewed. Studies were limited to English language, adult age, and human subjects.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Selection and Data Extraction:<\/jats:title>\n                    <jats:p>All articles identified from the data sources were evaluated. Studies that measured ribavirin concentrations or dose and treatment response were included in the review.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Synthesis:<\/jats:title>\n                    <jats:p>While monitoring of ribavirin plasma concentrations to improve treatment response in patients with chronic hepatitis C has been described in the literature, the utility of TDM for ribavirin in this group of patients has not been systematically studied. Thus, a previously published 9-step decision-making algorithm was employed to help determine whether TDM is warranted, based on currently available evidence. Thirty articles involving patients with chronic hepatitis C mono-infection, 12 for hepatitis C\u2013HIV coinfection, 5 for renal dysfunction, and 5 for post\u2013liver transplant patients were reviewed. In all subpopulations, studies exist that either support or refute the usefulness of ribavirin TDM. Additionally, the majority of the included studies had methodologic limitations, such as small sample size, retrospective analyses, and lack of p value adjustment for multiple analyses. Large randomized controlled trials would help to definitively answer this question.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>There is conflicting evidence about the existence of a correlation between ribavirin concentrations and virologic response or development of toxicity. This inconsistent evidence, coupled with the currently employed effective strategies that maximize sustained virologic response and minimize development of anemia, precludes the utility of TDM for ribavirin.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1345\/aph.1m225","type":"journal-article","created":{"date-parts":[[2009,11,17]],"date-time":"2009-11-17T23:13:33Z","timestamp":1258499613000},"page":"2044-2063","source":"Crossref","is-referenced-by-count":18,"title":["The Utility of Therapeutic Drug Monitoring for Ribavirin in Patients with Chronic Hepatitis C\u2014A Critical Review"],"prefix":"10.1177","volume":"43","author":[{"given":"Alice HW","family":"Chan","sequence":"first","affiliation":[{"name":"Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, British Columbia, Canada; now, Clinical Pharmacist\/Educator, Alberta Health Services, Edmonton, Alberta, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nilufar","family":"Partovi","sequence":"additional","affiliation":[{"name":"Vancouver Coastal Health Authority; Clinical Professor, Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mary HH","family":"Ensom","sequence":"additional","affiliation":[{"name":"Doctor of Pharmacy Program, Faculty of Pharmaceutical Sciences, and Distinguished University Scholar, The University of British Columbia; Clinical Pharmacy Specialist, Children's and Women's Health Centre of British Columbia, Vancouver"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2009,11,17]]},"reference":[{"key":"bibr1-aph.1M225","first-page":"1","volume":"57","author":"Wasley A","year":"2008","journal-title":"Surveillance for acute viral hepatitis\u2014United States"},{"key":"bibr2-aph.1M225","unstructured":"HepatitisC. Ottawa, ON: Public Health Agency of Canada, www.phacaspc.gc.ca\/hepc\/index_e.html (accessed 2008 Mar 30)."},{"key":"bibr3-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1002\/hep.510260721"},{"key":"bibr4-aph.1M225","first-page":"1147","volume":"39","author":"Strader DB","year":"2004","journal-title":"Diagnosis, management, and treatment of hepatitis C. Hepatology"},{"key":"bibr5-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.1030034"},{"key":"bibr6-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2125.1998.00836.x"},{"key":"bibr7-aph.1M225","doi-asserted-by":"publisher","DOI":"10.2165\/00003495-200363070-00008"},{"key":"bibr8-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2036.2002.01326.x"},{"key":"bibr9-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1053\/he.2000.5789"},{"key":"bibr10-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(01)06102-5"},{"key":"bibr11-aph.1M225","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-140-5-200403020-00010"},{"key":"bibr12-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1002\/hep.21932"},{"key":"bibr13-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2006.10.008"},{"key":"bibr14-aph.1M225","author":"Reddy R","year":"2008","journal-title":"Presented at: The Liver Meeting 2008: 59th Annual Meeting of the American Association for the Study of Liver Disease (AASLD)"},{"key":"bibr15-aph.1M225","author":"Oze T","year":"2008","journal-title":"Presented at: The Liver Meeting 2008: 59th Annual Meeting of the American Association for the Study of Liver Disease (AASLD)"},{"key":"bibr16-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkn421"},{"key":"bibr17-aph.1M225","doi-asserted-by":"publisher","DOI":"10.2165\/00003088-199834040-00001"},{"key":"bibr18-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1155\/2007\/138245"},{"key":"bibr19-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2007.02.018"},{"key":"bibr20-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(06)80739-7"},{"key":"bibr21-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(07)61608-0"},{"key":"bibr22-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.24.5.696"},{"key":"bibr23-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.47.1.124-129.2003"},{"key":"bibr24-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1097\/00007691-200004000-00013"},{"key":"bibr25-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1016\/S0731-7085(02)00003-1"},{"key":"bibr26-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.48.10.3813-3816.2004"},{"key":"bibr27-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1002\/elps.200305819"},{"key":"bibr28-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1097\/FTD.0b013e31815bddf3"},{"key":"bibr29-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.43.11.2716"},{"key":"bibr30-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1016\/0378-4347(87)80172-X"},{"key":"bibr31-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1093\/chromsci\/41.5.255"},{"key":"bibr32-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.33.3.311"},{"key":"bibr33-aph.1M225","author":"Alsio A","year":"2008","journal-title":"Presented at The Liver Meeting 2008:59th Annual Meeting of the American Association for the Study of Liver Disease (AASLD)"},{"key":"bibr34-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1007\/s00535-004-1483-x"},{"key":"bibr35-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1159\/000081741"},{"key":"bibr36-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2893.2006.00803.x"},{"key":"bibr37-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(08)60012-4"},{"key":"bibr38-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1159\/000090942"},{"key":"bibr39-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1016\/j.hepres.2005.10.003"},{"key":"bibr40-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1097\/00007691-200010000-00010"},{"key":"bibr41-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1067\/mcp.2002.127112"},{"key":"bibr42-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2893.2003.00475.x"},{"key":"bibr43-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1002\/hep.20563"},{"key":"bibr44-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1002\/hep.22217"},{"key":"bibr45-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1097\/00007691-200402000-00004"},{"key":"bibr46-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(09)60632-2"},{"key":"bibr47-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1177\/135965350801300401"},{"key":"bibr48-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1089\/aid.2007.0011"},{"key":"bibr49-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00079-06"},{"key":"bibr50-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1002\/hep.22543"},{"key":"bibr51-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2125.2006.02741.x"},{"key":"bibr52-aph.1M225","author":"Souvignet C","year":"2005","journal-title":"J Hepatol"},{"key":"bibr53-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1159\/000050085"},{"key":"bibr54-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2125.2003.01780.x"},{"key":"bibr55-aph.1M225","doi-asserted-by":"publisher","DOI":"10.2133\/dmpk.19.438"},{"key":"bibr56-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1086\/523585"},{"key":"bibr57-aph.1M225","unstructured":"Hospices Civils deLyon. RIBAJUSTE Clinical Trial Investigating the Efficacy and Safety of Dose Adaptation of Ribavirin. In: www.ClinicalTrials.gov. Bethesda, MD: National Library of Medicine (US). 2000-(cited 2009 Oct 31). Available from: http:\/\/clinicaltrials.gov\/ct2\/show\/NCT00485342?term=RIBAJUSTE&rank=1.NLM Identifier: NCT 00485342."},{"key":"bibr58-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkn013"},{"key":"bibr59-aph.1M225","author":"Barreiro P","year":"2007","journal-title":"Presented at: 14th Conference on Retroviruses and Opportunistic Infections"},{"key":"bibr60-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1177\/135965350701200815"},{"key":"bibr61-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2007.01.027"},{"key":"bibr62-aph.1M225","author":"Dominguez S","year":"2007","journal-title":"Presented at 14th Conference on Retroviruses and Opportunistic Infections"},{"key":"bibr63-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(08)60803-X"},{"key":"bibr64-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.21227"},{"key":"bibr65-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1177\/135965350501000512"},{"key":"bibr66-aph.1M225","author":"Quioc JJ","year":"2008","journal-title":"Presented at: The Liver Meeting 2008: 59th Annual Meeting of the American Association for the Study of Liver Disease (AASLD), San Francisco, CA, October 31-November 4"},{"key":"bibr67-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1097\/01.qai.0000170034.90438.68"},{"key":"bibr68-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2893.2001.00300.x"},{"key":"bibr69-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfg209"},{"key":"bibr70-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2893.2005.00680.x"},{"key":"bibr71-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2006.12.016"},{"key":"bibr72-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfm724"},{"key":"bibr73-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2893.2006.00720.x"},{"key":"bibr74-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1016\/j.transproceed.2005.07.057"},{"key":"bibr75-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1002\/lt.21184"},{"key":"bibr76-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1002\/lt.21121"},{"key":"bibr77-aph.1M225","author":"Sterneck M","year":"2006","journal-title":"Am J Transplant"},{"key":"bibr78-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1038\/clpt.2008.110"},{"key":"bibr79-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(08)60775-8"},{"key":"bibr80-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1097\/00007691-200212000-00004"},{"key":"bibr81-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2003.09.019"},{"key":"bibr82-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2125.2006.02704.x"},{"key":"bibr83-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1155\/2004\/326964"},{"key":"bibr84-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1097\/00042737-200509000-00003"},{"key":"bibr85-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2004.01.027"},{"key":"bibr86-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1002\/hep.20482"},{"key":"bibr87-aph.1M225","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa020047"}],"container-title":["Annals of Pharmacotherapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1345\/aph.1M225","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1345\/aph.1M225","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T11:11:13Z","timestamp":1777374673000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1345\/aph.1M225"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2009,11,17]]},"references-count":87,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2009,12]]}},"alternative-id":["10.1345\/aph.1M225"],"URL":"https:\/\/doi.org\/10.1345\/aph.1m225","relation":{},"ISSN":["1060-0280","1542-6270"],"issn-type":[{"value":"1060-0280","type":"print"},{"value":"1542-6270","type":"electronic"}],"subject":[],"published":{"date-parts":[[2009,11,17]]}}}