Glecaprevir/Pibrentasvir for Post Traumatic Stress Disorder

Objective: Posttraumatic Stress Disorder (PTSD) is a common condition with few effective medication treatments. Glecaprevir/Pibrentasvir (GLE/PIB), a treatment for hepatitis C virus (HCV) infection, demonstrated possible evidence of effectiveness for PTSD in an epidemiological study. We sought to determine if GLE/PIB decreases the symptoms of PTSD and modulates inflammation. Methods: An uncontrolled open trial was conducted at the Veterans Affairs Medical Center in White River Junction Vermont. Participants were veterans with PTSD and no HCV infection. Ten participants received Glecaprevir 100 mg/Pibrentasvir 40 mg, three tablets daily for 8 weeks. Symptoms were measured at baseline, mid-treatment, post-treatment, as well as at three- and six-months post-treatment. The primary outcome was PTSD symptoms as measured by the Clinician Administered PTSD Scale for DSM 5 (CAPS-5). Exploratory analyses were conducted to assess serum inflammatory biomarkers at baseline and post-treatment. Results: The mean baseline CAPS-5 score was 33.6 (SD = 3.3). Six-month post-treatment effects were large (CAPS-5: d = 1.6, p < 0.01). By the end of the study, eight patients met the criteria for response, including eight who met the criteria for loss of PTSD diagnosis and six who met the criteria for total remission of PTSD (CAPS-5 score of less than 12). Lower interleukin (IL)-27 levels prior to treatment were predictive of treatment response. Eight-week IL-9 levels changes with treatment were associated with symptom improvement. Conclusions: GLE/PIB may be an effective treatment for PTSD. Furthermore, treatment may modulate inflammatory responses in PTSD. Future studies are required to confirm these findings regarding GLE/PIB, PTSD, and inflammation.