Development of an evidence evaluation and synthesis system for drug-drug interactions, and its application to a systematic review of HIV and malaria co-infection.

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State: Public
Version: Final published version
License: CC BY 4.0
Serval ID
serval:BIB_7E2E6A799E25
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Development of an evidence evaluation and synthesis system for drug-drug interactions, and its application to a systematic review of HIV and malaria co-infection.
Journal
PloS one
Author(s)
Seden K., Gibbons S., Marzolini C., Schapiro J.M., Burger D.M., Back D.J., Khoo S.H.
ISSN
1932-6203 (Electronic)
ISSN-L
1932-6203
Publication state
Published
Issued date
2017
Peer-reviewed
Oui
Volume
12
Number
3
Pages
e0173509
Language
english
Notes
Publication types: Journal Article ; Systematic Review
Publication Status: epublish
Abstract
In all settings, there are challenges associated with safely treating patients with multimorbidity and polypharmacy. The need to characterise, understand and limit harms resulting from medication use is therefore increasingly important. Drug-drug interactions (DDIs) are prevalent in patients taking antiretrovirals (ARVs) and if unmanaged, may pose considerable risk to treatment outcome. One of the biggest challenges in preventing DDIs is the substantial gap between theory and clinical practice. There are no robust methods published for formally assessing quality of evidence relating to DDIs, despite the diverse sources of information. We defined a transparent, structured process for developing evidence quality summaries in order to guide therapeutic decision making. This was applied to a systematic review of DDI data with considerable public health significance: HIV and malaria.
This was a systematic review of DDI data between antiretrovirals and drugs used in prophylaxis and treatment of malaria. The data comprised all original research in humans that evaluated pharmacokinetic data and/or related adverse events when antiretroviral agents were combined with antimalarial agents, including healthy volunteers, patients with HIV and/or malaria, observational studies, and case reports. The data synthesis included 36 articles and conference presentations published via PubMed and conference websites/abstract books between 1987-August 2016. There is significant risk of DDIs between HIV protease inhibitors, or NNRTIs and artemesinin-containing antimalarial regimens. For many antiretrovirals, DDI studies with antimalarials were lacking, and the majority were of moderate to very low quality. Quality of evidence and strength of recommendation categories were defined and developed specifically for recommendations concerning DDIs.
There is significant potential for DDIs between antiretrovirals and antimalarials. The application of quality of evidence and strength of recommendation criteria to DDI data is feasible, and allows the assessment of DDIs to be robust, consistent, transparent and evidence-based.
Keywords
Antimalarials/therapeutic use, Antirheumatic Agents/therapeutic use, Coinfection/drug therapy, Drug Interactions, HIV Infections/drug therapy, Humans, Malaria/drug therapy, Polypharmacy, Prevalence, Reverse Transcriptase Inhibitors/therapeutic use
Pubmed
Web of science
Open Access
Yes
Create date
25/08/2023 5:17
Last modification date
06/08/2024 6:02
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