Prevalence of comedications and effect of potential drug-drug interactions in the Swiss HIV Cohort Study.

Details

Serval ID
serval:BIB_6BCAC526F0B2
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Prevalence of comedications and effect of potential drug-drug interactions in the Swiss HIV Cohort Study.
Journal
Antiviral Therapy
Author(s)
Marzolini C., Elzi L., Gibbons S., Weber R., Fux C., Furrer H., Chave J.P., Cavassini M., Bernasconi E., Calmy A., Vernazza P., Khoo S., Ledergerber B., Back D., Battegay M.
Working group(s)
Swiss HIV Cohort Study
Contributor(s)
Battegay M., Bernasconi E., Böni J., Bucher HC., Bürgisser P., Calmy A., Cattacin S., Cavassini M., Dubs R., Egger M., Elzi L., Fischer M., Flepp M., Fontana A., Francioli P., Furrer H., Fux C., Gorgievski M., Günthard H., Hirsch HH., Hirschel B., Hösli I., Kahlert Ch., Kaiser L., Karrer U., Kind C., Klimkait T., Ledergerber B., Martinetti G., Martinez B., Müller N., Nadal D., Opravil M., Paccaud F., Pantaleo G., Rauch A., Regenass S., Rickenbach M., Rudin C., Schmid P., Schultze D., Schüpbach J., Speck R., Taffé P., Tarr P., Telenti A., Trkola A., Vernazza P., Weber R., Yerly S.
ISSN
2040-2058 (Electronic)
ISSN-L
1359-6535
Publication state
Published
Issued date
2010
Volume
15
Number
3
Pages
413-423
Language
english
Notes
Publication types: Journal Article ; Research Support, Non-U.S. Gov't
Publication Status: ppublish
Abstract
BACKGROUND: Potential drug-drug interactions (PDDIs) might expand with new combination antiretroviral therapies (ART) and polypharmacy related to increasing age and comorbidities. We investigated the prevalence of comedications and PDDIs within a large HIV cohort, and their effect on ART efficacy and tolerability.
METHODS: All medications were prospectively recorded in 1,497 ART-treated patients and screened for PDDIs using a customized version of the Liverpool drug interactions database.
RESULTS: Overall, 68% (1,013/1,497) of patients had a comedication and 40% (599/1,497) had > or = 1 PDDI. Among patients with comedication, 2% (21/1,013) had red-flag interactions (contraindicated) and 59% (597/1,013) had orange-flag interactions (potential dose adjustment and/or close monitoring required). The latter involved mainly central nervous system drugs (49%), cardiovascular drugs (34%) and methadone (19%). In the multivariate analysis, factors associated with having a comedication were advanced age, female gender, obesity and HCV infection. Independent risk factors for PDDIs were regimens combining protease inhibitors and non-nucleoside reverse transcriptase inhibitors (odds ratio [OR] 3.06, 95% confidence interval [CI] 1.44-6.48), > or = 2 comedications (OR 1.89, 95% CI 1.32-2.70), current illicit drug use (OR 2.00, 95% CI 1.29-3.10) and patients with HCV infection (OR 1.74, 95% CI 1.19-2.56). Viral response was similar in patients with and without PDDIs (84.5% versus 86.4%; P=0.386). During follow-up, ART was modified in 134 patients with comedication regardless of the presence of PDDIs (P=0.524).
CONCLUSIONS: PDDIs increase with complex ART and comorbidities. No adverse effect was noted on ART efficacy or tolerability; however, most PDDIs affected comedication but were manageable through dose adjustment or monitoring.
Keywords
Anti-HIV Agents/administration & dosage, Central Nervous System Agents/administration & dosage, Cohort Studies, Comorbidity, Drug Interactions, Drug Therapy, Combination, HIV Infections/complications, HIV Infections/drug therapy, HIV Protease Inhibitors/administration & dosage, Humans, Methadone/administration & dosage, Polypharmacy, Prevalence, Reverse Transcriptase Inhibitors/administration & dosage, Switzerland
Pubmed
Web of science
Create date
01/07/2010 14:59
Last modification date
20/08/2019 15:25
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