RT Journal Article
T1 Real clinical impact of drug-drug interactions of immunosuppressants in transplant patients
A1 Isabel Gago-Sanchez, Ana
A1 Font, Pilar
A1 Cardenas, Manuel
A1 Dolores Aumente, Maria
A1 Ramon Del Prado, Jose
A1 Angel Calleja, Miguel
K1 adverse drug events
K1 clinically relevant
K1 drug-drug interactions
K1 immunosuppressants
K1 prevalence
K1 transplant
K1 Stem-cell transplantation
K1 Hospitalized-patients
K1 Azole antifungals
K1 Management
K1 Polypharmacy
K1 Prevalence
K1 Tacrolimus
K1 Magnitude
K1 Agents
K1 Care
AB 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.
PB John wiley & sons ltd
SN 2052-1707
YR 2021
FD 2021-12-01
LK https://hdl.handle.net/10668/25492
UL https://hdl.handle.net/10668/25492
LA en
DS RISalud
RD Apr 17, 2025