A Review of Drug-Drug Interactions for Biologic Drugs Used in the Treatment of Psoriasis

2020 ◽  
pp. 120347542095242
Author(s):  
Miriam Armanious ◽  
Ronald Vender
Keyword(s):  
Drug Interaction ◽  
Drug Interactions ◽  
Potential Drug ◽  
Risk Of Infection ◽  
Biologic Therapies ◽  
Biologic Drugs ◽  
Increased Risk ◽  
Pubmed Search ◽  
Low Levels ◽  
Biologic Drug

Biologic drugs are increasingly being prescribed for the treatment of psoriasis. Very little information is available in the literature regarding potential drug interactions with these medications. This paper serves as a guide for prescribers to be aware of possible interactions between biologic drugs approved for the treatment of psoriasis in North America and concomitant therapies. Objective To provide an overview of reported drug interactions between biologic drugs and concomitant therapies. Methods Reports of potential drug interactions were compiled through a search of Micromedex, drug monographs (Canadian, American, and European), as well as a PubMed search of each biologic drug with the term “drug interaction.” Conclusion Generally, caution should be exercised when multiple immunosuppressive therapies are prescribed due to increased risk of infection. However, this is more the result of a synergistic effect as opposed to a true drug interaction. There have been cases where multiple biologic therapies have been concomitantly used without adverse events, as their mechanisms involved different pathways. The sources used to compile this guide were often comprised of low levels of evidence, reinforcing the idea that further studies are required to better direct prescribers.

scholarly journals Analysis of potential drug interactions and adverse reactions to nonsteroidal anti-inflammatory drugs among the elderly

2016 ◽  
Vol 19 (3) ◽  
pp. 533-544 ◽  
Author(s):  
Tiago Aparecido Maschio de Lima ◽  
Adriana Antônia da Cruz Furini ◽  
Tábata Salum Calille Atique ◽  
Patricia Di Done ◽  
Ricardo Luiz Dantas Machado ◽  
...  
Keyword(s):  
Drug Interactions ◽  
Prescription Drugs ◽  
Adverse Reactions ◽  
Drug Distribution ◽  
The Elderly ◽  
Elderly Persons ◽  
Potential Drug ◽  
Increased Risk ◽  
Chi Squared ◽  
Elderly Users

Abstract Objective: The aim of the present study was to analyze potential drug interactions and adverse reactions to NSAIDs in elderly users of a private drug distribution service. Method: A prospective, exploratory and descriptive study with a quantitative approach was performed. The elderly users of NSAIDs attended by the service were interviewed and their prescriptions analyzed between May and September, 2014. Analysis of drug interactions was performed through computerized databases. The post-sales analysis of adverse reactions was performed using the Adverse Drug Reaction Probability Scale. Statistical analysis was performed with the Chi-squared and Fisher's Exact tests. Results: The study evaluated 200 elderly persons, among whom women predominated (56.5%). The average age was 65 years ±10. The NSAIDs accounted for 38.7% of prescription drugs used, and included dipyrone (26.9%), nimesulide (22.8%) and ketoprofen (16.3%). A total of 8.5% of such drugs were considered inappropriate medications for the elderly. A total of 104 potential drug interactions were identified, of which 24% were considered highly clinically significant. The NSAIDs with the greatest risk of interactions were ketoprofen 46.2%, ketorolac 14.4%, nimesulide 12.5% and diclofenac 9.6%. In post-sales monitoring 30.5% of the elderly persons reported undesirable symptoms after the use of NSAIDs, with stomach discomfort the most prevalent (17%). Conclusion: The present study confirmed the importance of monitoring the use of NSAIDs among the elderly due to the increased risk of drug interactions and adverse reactions associated with age, concomitant diseases, multi- prescriptions and polypharmacy. The choice of appropriate drugs for the elderly, the reconciliation of all the medications taken by the patient, and effective pharmaceutical care are measures that can contribute to the rational and safe use of NSAIDs.

scholarly journals Review of Impact and Handling of Potential Antihypertensive Drug Interactions in Chronic Kidney Disease Patients

2021 ◽  
Vol 7 (1) ◽  
pp. 39-53
Author(s):  
Ni Made Susilawati ◽  
Eli Halimah ◽  
Siti Saidah
Keyword(s):  
Drug Interaction ◽  
Drug Interactions ◽  
Heart Function ◽  
Mortality Rates ◽  
Morbidity And Mortality ◽  
Potential Drug ◽  
Analysis Program ◽  
Drug Related Problems ◽  
Related Effect ◽  
Complete Knowledge

Drug interaction is a type of Drug-Related Problems (DRPs) that caneventually increase morbidity and mortality rates. CKD patients have asignificant risk of developing polypharmacy due to comorbid diseases andpharmacokinetics' alteration. The literature review was conducted byexploring all of the articles related to the drug interaction using druginteraction analysis program in CKD patients, which obtained from threedatabases, namely Google Scholar, PubMed, and Science Direct, usingseveral keywords combination. Based on the comprehensive reviewsconducted, it is known that the most common effects of antihypertensivedrug interactions in CKD patients are decreasing effects of antihypertensivedrugs, hypotension, and hyperkalemia. Handling management used for theemergence of potential drug interactions is based on the severity of the druginteractions and complete knowledge of the patients' clinical condition. Themanagement of drug interaction by monitoring blood pressure, diuresis, andpotassium levels; Monitor the related effect symptoms; Monitor the fluidand body weight; Monitor the kidney and heart function. On the conditionwhere the handling management of potential drug interactions is not carriedout, elevated morbidity and mortality rates are the risks of complicationsarising from the drug interactions.

Risk of serious infections in tocilizumab versus other biologic drugs in patients with rheumatoid arthritis: a multidatabase cohort study

2019 ◽  
Vol 78 (4) ◽  
pp. 456-464 ◽  
Author(s):  
Ajinkya Pawar ◽  
Rishi J Desai ◽  
Daniel H Solomon ◽  
Adrian J Santiago Ortiz ◽  
Sara Gale ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Cohort Study ◽  
Soft Tissue ◽  
Bacterial Infection ◽  
Opportunistic Infection ◽  
Soft Tissue Infections ◽  
Upper Respiratory Tract ◽  
Biologic Drugs ◽  
Increased Risk ◽  
Biologic Drug

ObjectiveTo investigate the rate of serious bacterial, viral or opportunistic infection in patients with rheumatoid arthritis (RA) starting tocilizumab (TCZ) versus tumour necrosis factor inhibitors (TNFi) or abatacept.MethodsUsing claims data from US Medicare from 2010 to 2015, and IMS and MarketScan from 2011 to 2015, we identified adults with RA who initiated TCZ or TNFi (primary comparator)/abatacept (secondary comparator) with prior use of ≥1 different biologic drug or tofacitinib. The primary outcome was hospitalised serious infection (SI), including bacterial, viral or opportunistic infection. To control for >70 confounders, TCZ initiators were propensity score (PS)-matched to TNFi or abatacept initiators. Database-specific HRs were combined by a meta-analysis.ResultsThe primary cohort included 16 074 TCZ PS-matched to 33 109 TNFi initiators. The risk of composite SI was not different between TCZ and TNFi initiators (combined HR 1.05, 95% CI 0.95 to 1.16). However, TCZ was associated with an increased risk of serious bacterial infection (HR 1.19, 95% CI 1.07 to 1.33), skin and soft tissue infections (HR 2.38, 95% CI 1.47 to 3.86), and diverticulitis (HR 2.34, 95% CI 1.64 to 3.34) versus TNFi. An increased risk of composite SI, serious bacterial infection, diverticulitis, pneumonia/upper respiratory tract infection and septicaemia/bacteraemia was observed in TCZ versus abatacept users.ConclusionsThis large multidatabase cohort study found no difference in composite SI risk in patients with RA initiating TCZ versus TNFi after failing ≥1 biologic drug or tofacitinib. However, the risk of serious bacterial infection, skin and soft tissue infections, and diverticulitis was higher in TCZ versus TNFi initiators. The risk of composite SI was higher in TCZ initiators versus abatacept.

scholarly journals Emerging and experimental treatments for COVID-19 and drug interactions with psychotropic agents

2020 ◽  
Vol 10 ◽  
pp. 204512532093530 ◽  
Author(s):  
Delia Bishara ◽  
Chris Kalafatis ◽  
David Taylor
Keyword(s):  
Drug Interaction ◽  
Adverse Effects ◽  
Drug Interactions ◽  
Clinical Trial Data ◽  
Potential Drug ◽  
Qtc Prolongation ◽  
Experimental Drugs ◽  
Psychotropic Agents ◽  
The Common ◽  
Experimental Treatments

As yet, no agents have been approved for the treatment of COVID-19, although several experimental drugs are being used off licence. These may have serious adverse effects and potential drug interactions with psychotropic agents. We reviewed the common agents being used across the world for the treatment of COVID-19 and investigated their drug interaction potential with psychotropic agents using several drug interaction databases and resources. A preliminary search identified the following drugs as being used to treat COVID-19 symptoms: atazanavir (ATV), azithromycin (AZI), chloroquine (CLQ)/hydroxychloroquine (HCLQ), dipyridamole, famotidine (FAM), favipiravir, lopinavir/ritonavir (LPV/r), nitazoxanide, remdesivir, ribavirin and tocilizumab. Many serious adverse effects and potential drug interactions with psychotropic agents were identified. The most problematic agents were found to be ATV, AZI, CLQ, HCLQ, FAM and LPV/r in terms of both pharmacokinetic as well as serious pharmacodynamic drug interactions, including QTc prolongation and neutropenia. Significant caution should be exercised if using any of the medications being trialled for the treatment of COVID-19 until robust clinical trial data are available. An even higher threshold of vigilance should be maintained for patients with pre-existing conditions and older adults due to added toxicity and drug interactions, especially with psychotropic agents.

Potential Drug Interactions— Fact or Fallacy?

1975 ◽  
Vol 9 (11) ◽  
pp. 586-590 ◽  
Author(s):  
Curtis D. Black ◽  
Nicholas G. Popovich
Keyword(s):  
Drug Interaction ◽  
Drug Interactions ◽  
Patient Care ◽  
Clinical Studies ◽  
Literature Search ◽  
Potential Drug ◽  
Careful Evaluation ◽  
Current Drug ◽  
Drug Drug Interaction

At present, the pharmacist is faced with a perplexing number of potential drug interactions as they relate to patient care. The purpose of the investigation was to evaluate current drug-drug interaction literature, specifically gastrointestinal drug interactions. Literature search and review evaluated the authoritative basis on which conclusions were made. From this, a review was written to illustrate fallacies and misconceptions that could be derived from the literature with the intent it would serve as a guide in interpreting and evaluating drug-drug interactions. The overall study illustrates the vast need for careful evaluation of drug interaction literature before erroneous recommendations are made on conceivably inconclusive clinical studies.

scholarly journals A Minimal Information Model for Potential Drug-Drug Interactions

2021 ◽  
Vol 11 ◽  
Author(s):  
Harry Hochheiser ◽  
Xia Jing ◽  
Elizabeth A. Garcia ◽  
Serkan Ayvaz ◽  
Ratnesh Sahay ◽  
...  
Keyword(s):  
Drug Interaction ◽  
Drug Interactions ◽  
Best Practice ◽  
Task Force ◽  
Information Model ◽  
Potential Drug ◽  
Community Group ◽  
Drug Drug Interaction ◽  
Potential Interactions ◽  
Minimal Information

Despite the significant health impacts of adverse events associated with drug-drug interactions, no standard models exist for managing and sharing evidence describing potential interactions between medications. Minimal information models have been used in other communities to establish community consensus around simple models capable of communicating useful information. This paper reports on a new minimal information model for describing potential drug-drug interactions. A task force of the Semantic Web in Health Care and Life Sciences Community Group of the World-Wide Web consortium engaged informaticians and drug-drug interaction experts in in-depth examination of recent literature and specific potential interactions. A consensus set of information items was identified, along with example descriptions of selected potential drug-drug interactions (PDDIs). User profiles and use cases were developed to demonstrate the applicability of the model. Ten core information items were identified: drugs involved, clinical consequences, seriousness, operational classification statement, recommended action, mechanism of interaction, contextual information/modifying factors, evidence about a suspected drug-drug interaction, frequency of exposure, and frequency of harm to exposed persons. Eight best practice recommendations suggest how PDDI knowledge artifact creators can best use the 10 information items when synthesizing drug interaction evidence into artifacts intended to aid clinicians. This model has been included in a proposed implementation guide developed by the HL7 Clinical Decision Support Workgroup and in PDDIs published in the CDS Connect repository. The complete description of the model can be found at https://w3id.org/hclscg/pddi.

scholarly journals Assessment of Prevalence, Drug Utilization Pattern and Potential Drug-Drug Interactions Among Hepatic Impairment Patients

2021 ◽  
Vol 69 (1) ◽  
Author(s):  
Dr. Natish Belbase ◽  
Dr. Dinesh Raj Neupane ◽  
Dr. Jaiji Thomas ◽  
Dr. Rini Ponnachan ◽  
Dr. Ramesh Basnet ◽  
...  
Keyword(s):  
Drug Interaction ◽  
Liver Disease ◽  
Drug Interactions ◽  
Drug Utilization ◽  
Alcoholic Liver Disease ◽  
Hepatic Impairment ◽  
Potential Drug ◽  
Utilization Pattern ◽  
Pharmacodynamic Interaction ◽  
Co Morbidity

The majority of drugs are metabolised in liver and are known to be hepatotoxic. So, the Drug Utilization Evaluation (DUE) studies become potential tool in hepatic impairment patient to ensure drugs are used appropriately, safely and effectively in order to improve overall health of patient. Drug-Drug Interactions are major cause of concern among hepatic impairment patients due to co-morbidity conditions and wide class of drugs they receive. The clinical result of DDI may manifest as synergism, antagonism or idiosyncratic. This study is aimed to generate data on drug utilization pattern and to assess the prevalence of potential drug-drug interactions (pDDIs) among hospitalised hepatic impairment patients. A prospective observational study was carried out for six months among inpatients of the medicine department of Chigateri District Hospital, Karnataka, India. Potential drug-drug interactions (pDDIs) were analysed using Lexicomp, Medscape drug interaction checker, Stockley’s drug interaction checker. Overall 135 patients were enrolled the study. In this study, 80.68% patients were male. The most common affected age group was 40-59 years. Alcoholic liver disease (46.66%) and chronic liver disease (27.40%) were the most prevalent hepatic condition. Anemia and portal hypertension were the most likely associated comorbidities. Out of 1097 drugs, 569 drugs were used specifically for hepatic impairment. Diuretics (23.02%) were the most frequently prescribed drugs followed by gallstone dissolution agents (18.27%). Total of 264 pDDIs, were identified, of which 76(28.78%) were minor, 180(68.18%) were moderate and 8(3.03%) were major. Potential DDIs were significantly higher in patients taking ?9 medicines (63.63%), hospitalization ?7 days (67.64%) and with one co-morbidity conditions (43.18%). Pharmacodynamic interaction 197 (74.62%) was observed more than that of pharmacokinetic interactions 67(25.37%). The prevalence of alcoholic liver disease in this study was reported th

scholarly journals ASSESSMENT OF POTENTIAL DRUG–DRUG INTERACTION IN STROKE PATIENTS

2016 ◽  
Vol 8 (12) ◽  
pp. 221 ◽  
Author(s):  
Venkateswaramurthy N. ◽  
Krishnaveni K ◽  
Mercy Freeda R. ◽  
Sambath Kumar R.
Keyword(s):  
Drug Interaction ◽  
Health Care Cost ◽  
Tertiary Care ◽  
Significant Proportion ◽  
Potential Drug ◽  
Severity Scale ◽  
Stroke Patients ◽  
Pharmacodynamic Interactions ◽  
Increased Risk ◽  
Drug Drug Interaction

<p><strong>Objective: </strong>To assess the incidence and pattern of potential drug-drug interaction (pDDI) in hospitalized stroke patients.</p><p><strong>Methods: </strong>A retrospective study was carried out in a medical record from a tertiary care teaching hospital for a 4 mo period from November 2015-February 2016. The total of 200 prescriptions was analyzed during the study period.</p><p><strong>Results: </strong>A significant proportion of patients with pDDIs were males (61.5%) followed by females (38.5%). Among the 200 prescriptions, 179(89.5%) were confirmed with minimum one potential drug-drug interaction. Moreover, patients prescribed with more than 5 drugs developed a higher number of interactions. Based on severity scale, there were 125 major, 375 moderate and 128 minor interactions were observed. The pharmacodynamic interactions were 286 while the pharmacokinetic were 342.</p><p><strong>Conclusion: </strong>The study highlighted the pDDIs which were high in stroke patients greater than 40 y. pDDIs in prescriptions contained multi-drug therapy is a major concern as such interaction may lead to increased risk of hospitalization and higher health care cost. The majority of interactions were pharmacokinetic in nature, having moderate severity. In this study pDDIs mainly occurred between antihypertensive, anticoagulants and antiplatelet.</p>

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