Cargando…

Real clinical impact of drug–drug interactions of immunosuppressants in transplant patients

The main objective was to determine the prevalence of real drug–drug interactions (DDIs) of immunosuppressants in transplant patients. We conducted a prospective, observational 1‐year study at a tertiary hospital, including all transplanted patients. We evaluated data from monitoring blood concentra...

Descripción completa

Detalles Bibliográficos
Autores principales: Gago‐Sánchez, Ana Isabel, Font, Pilar, Cárdenas, Manuel, Aumente, María Dolores, Del Prado, José Ramón, Calleja, Miguel Ángel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8578873/
https://www.ncbi.nlm.nih.gov/pubmed/34755493
http://dx.doi.org/10.1002/prp2.892
_version_ 1784596327400734720
author Gago‐Sánchez, Ana Isabel
Font, Pilar
Cárdenas, Manuel
Aumente, María Dolores
Del Prado, José Ramón
Calleja, Miguel Ángel
author_facet Gago‐Sánchez, Ana Isabel
Font, Pilar
Cárdenas, Manuel
Aumente, María Dolores
Del Prado, José Ramón
Calleja, Miguel Ángel
author_sort Gago‐Sánchez, Ana Isabel
collection PubMed
description The main objective was to determine the prevalence of real drug–drug interactions (DDIs) of immunosuppressants in transplant patients. We conducted a prospective, observational 1‐year study at a tertiary hospital, including all transplanted patients. We evaluated data from monitoring blood concentrations of immunosuppressive drugs and adverse drug events (ADEs) caused by DDIs. The DDIs were classified as C, D, or X according to their Lexi‐Interact rating (C = monitor therapy, D = consider therapy modification, X = avoid combination). The clinical importance of real DDIs was expressed in terms of patient outcomes. The causality of DDIs was determined using Drug Interaction Probability Scale. The data were analyzed using Statistical Package for Social Sciences v. 25.0. A total of 309 transplant patients were included. Their mean age was 52.0 ± 14.7 years (18–79) and 69.9% were male. The prevalence of real DDIs was 21.7%. Immunosuppressive drugs administered with antifungal azoles and tacrolimus (TAC) with nifedipine have a great clinical impact. Real DDIs caused ADEs in 22 patients. The most common clinical outcome was nephrotoxicity (1.6%; n = 5), followed by hypertension (1.3%; n = 4). Suggestions for avoiding category D and X DDIs included: changing the immunosuppressant dosage, using paracetamol instead of non‐steroidal anti‐inflammatory drugs, and interrupting atorvastatin. The number of drugs prescribed and having been prescribed TAC was associated with an increased risk of real DDIs. There are many potential DDIs described in the literature but only a small percentage proved to be real DDIs, based on the patients´ outcomes.
format Online
Article
Text
id pubmed-8578873
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher John Wiley and Sons Inc.
record_format MEDLINE/PubMed
spelling pubmed-85788732021-11-15 Real clinical impact of drug–drug interactions of immunosuppressants in transplant patients Gago‐Sánchez, Ana Isabel Font, Pilar Cárdenas, Manuel Aumente, María Dolores Del Prado, José Ramón Calleja, Miguel Ángel Pharmacol Res Perspect Original Articles The main objective was to determine the prevalence of real drug–drug interactions (DDIs) of immunosuppressants in transplant patients. We conducted a prospective, observational 1‐year study at a tertiary hospital, including all transplanted patients. We evaluated data from monitoring blood concentrations of immunosuppressive drugs and adverse drug events (ADEs) caused by DDIs. The DDIs were classified as C, D, or X according to their Lexi‐Interact rating (C = monitor therapy, D = consider therapy modification, X = avoid combination). The clinical importance of real DDIs was expressed in terms of patient outcomes. The causality of DDIs was determined using Drug Interaction Probability Scale. The data were analyzed using Statistical Package for Social Sciences v. 25.0. A total of 309 transplant patients were included. Their mean age was 52.0 ± 14.7 years (18–79) and 69.9% were male. The prevalence of real DDIs was 21.7%. Immunosuppressive drugs administered with antifungal azoles and tacrolimus (TAC) with nifedipine have a great clinical impact. Real DDIs caused ADEs in 22 patients. The most common clinical outcome was nephrotoxicity (1.6%; n = 5), followed by hypertension (1.3%; n = 4). Suggestions for avoiding category D and X DDIs included: changing the immunosuppressant dosage, using paracetamol instead of non‐steroidal anti‐inflammatory drugs, and interrupting atorvastatin. The number of drugs prescribed and having been prescribed TAC was associated with an increased risk of real DDIs. There are many potential DDIs described in the literature but only a small percentage proved to be real DDIs, based on the patients´ outcomes. John Wiley and Sons Inc. 2021-11-09 /pmc/articles/PMC8578873/ /pubmed/34755493 http://dx.doi.org/10.1002/prp2.892 Text en © 2021 The Authors. Pharmacology Research & Perspectives published by British Pharmacological Society and American Society for Pharmacology and Experimental Therapeutics and John Wiley & Sons Ltd. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Original Articles
Gago‐Sánchez, Ana Isabel
Font, Pilar
Cárdenas, Manuel
Aumente, María Dolores
Del Prado, José Ramón
Calleja, Miguel Ángel
Real clinical impact of drug–drug interactions of immunosuppressants in transplant patients
title Real clinical impact of drug–drug interactions of immunosuppressants in transplant patients
title_full Real clinical impact of drug–drug interactions of immunosuppressants in transplant patients
title_fullStr Real clinical impact of drug–drug interactions of immunosuppressants in transplant patients
title_full_unstemmed Real clinical impact of drug–drug interactions of immunosuppressants in transplant patients
title_short Real clinical impact of drug–drug interactions of immunosuppressants in transplant patients
title_sort real clinical impact of drug–drug interactions of immunosuppressants in transplant patients
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8578873/
https://www.ncbi.nlm.nih.gov/pubmed/34755493
http://dx.doi.org/10.1002/prp2.892
work_keys_str_mv AT gagosanchezanaisabel realclinicalimpactofdrugdruginteractionsofimmunosuppressantsintransplantpatients
AT fontpilar realclinicalimpactofdrugdruginteractionsofimmunosuppressantsintransplantpatients
AT cardenasmanuel realclinicalimpactofdrugdruginteractionsofimmunosuppressantsintransplantpatients
AT aumentemariadolores realclinicalimpactofdrugdruginteractionsofimmunosuppressantsintransplantpatients
AT delpradojoseramon realclinicalimpactofdrugdruginteractionsofimmunosuppressantsintransplantpatients
AT callejamiguelangel realclinicalimpactofdrugdruginteractionsofimmunosuppressantsintransplantpatients