Safety and efficacy of sofosbuvir/velpatasvir/voxilaprevir in post-liver transplant patients with previous direct-acting antiviral failure: Six case reports

Table 3 Immunosuppressive medication changes while receiving sofosbuvir/velpatasvir/voxilaprevir

	1	2	3	4	5	6
Baseline regimen	Tacrolimus 3/4	Tacrolimus 2/1	Tacrolimus 2/2	Tacrolimus 4/4	Tacrolimus 5/5	Tacrolimus 3/3
	MMF 1000 mg BID	MMF 500 mg BID	MMF 500 mg BID			MMF 360 mg BID
	Prednisone 20 mg QD					Prednisone 10 mg QD
Week 1	TL: 14.5 ng/mL ↓
	Tacrolimus 3/3
	MMF 1000 mg BID
	Prednisone 15 mg QD
Week 2	TL: 12.9 ng/mL ↓
	Tacrolimus 3/2
	MMF 1000 mg BID
	Prednisone 15 mg QD
Week 3	TL: 8.3 ng/mL ↓	TL: 13.5 ng/mL↓		TL: 8.6 ng/mL ↓
	Tacrolimus 3/2	Tacrolimus 1/1		Tacrolimus 4/3
	MMF 1000 mg BID	MMF 500 mg BID
	Prednisone 10 mg QD
Week 4					TL: 8.9 ng/mL↓
					Tacrolimus 5/4
Week 5	TL: 8.8 ng/mL↓			TL: 10.9 ng/Ml ↓
	Tacrolimus 3/2			Tacrolimus 3/3
	MMF 1000 mg BID
	Prednisone 5 mg QD
Week 6	TL: 11.5 ng/mL↓				TL: 8.7 ng/mL
	Tacrolimus 2/2				Tacrolimus 4/4
	MMF 1000 mg BID
	Prednisone 5 mg QD
Week 7
Week 8
Week 9		MMF discontinued2	TL: 2.7 ng/mL↓
			Tacrolimus 3/2
			MMF 500 mg BID
Week 10		TL: 10.7 ng/mL ↓
		Tacrolimus 1/0.5
Week 11	TL: 14.1 ng/mL ↓
	Tacrolimus 1/1
	MMF discontinued1
	Prednisone 5mg QD
Week 12	Tacrolimus 1/1	Tacrolimus 1/0.5	TL: 4.6 ng/mL ↓	Tacrolimus 3/23	Tacrolimus 4/4	TL: 2.2 ng/mL ↓
	Prednisone 5 mg QD		Tacrolimus 3/3			Tacrolimus 3/4
			MMF 500 mg BID			MMF 360 mg BID
						Prednisone 10 mg QD

¹Patient developed sepsis from cholangitis.

²Per institution protocol at three months post-transplant.

³Dose adjusted preemptively as fluconazole was added.

MMF: Mycophenolate; TL: Tacrolimus trough level; BID: Two times daily; QD: Once daily.