Drug–drug interactions between treatment specific pharmacotherapy and concomitant medication in patients with COVID-19 in the first wave in Spain

Abstract Primary aim was to assess prevalence and severity of potential and real drug–drug interactions (DDIs) among therapies for COVID-19 and concomitant medications in hospitalized patients with confirmed SARS-CoV-2 infection. The secondary aim was to analyze factors associated with rDDIs. An obs...

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Autores principales:	M. D. Cantudo-Cuenca, Antonio Gutiérrez-Pizarraya, Ana Pinilla-Fernández, Enrique Contreras-Macías, M. Fernández‑Fuertes, F. A Lao‑Domínguez, Pilar Rincón, Juan Antonio Pineda, Juan Macías, Ramón Morillo-Verdugo
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/b63d4137a2064352b56e7152c9097cb1
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spelling	oai:doaj.org-article:b63d4137a2064352b56e7152c9097cb12021-12-02T16:04:13ZDrug–drug interactions between treatment specific pharmacotherapy and concomitant medication in patients with COVID-19 in the first wave in Spain10.1038/s41598-021-91953-22045-2322https://doaj.org/article/b63d4137a2064352b56e7152c9097cb12021-06-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-91953-2https://doaj.org/toc/2045-2322Abstract Primary aim was to assess prevalence and severity of potential and real drug–drug interactions (DDIs) among therapies for COVID-19 and concomitant medications in hospitalized patients with confirmed SARS-CoV-2 infection. The secondary aim was to analyze factors associated with rDDIs. An observational single center cohort study conducted at a tertiary hospital in Spain from March 1st to April 30th. rDDIs refer to interaction with concomitant drugs prescribed during hospital stay whereas potential DDIs (pDDIs) refer to those with domiciliary medication. DDIs checked with The University of Liverpool resource. Concomitant medications were categorized according to the Anatomical Therapeutic Chemical classification system. Binomial logistic regression was carried out to identify factors associated with rDDIs. A total of 174 patients were analyzed. DDIs were detected in 152 patients (87.4%) with a total of 417 rDDIs between COVID19-related drugs and involved hospital concomitant medication (60 different drugs) while pDDIs were detected in 105 patients (72.9%) with a total of 553 pDDIs. From all 417 rDDIs, 43.2% (n = 180) were associated with lopinavir/ritonavir and 52.9% (n = 221) with hydroxychloroquine, both of them the most prescribed (106 and 165 patients, respectively). The main mechanism of interaction observed was QTc prolongation. Clinically relevant rDDIs were identified among 81.1% (n = 338) (‘potential interactions’) and 14.6% (n = 61) (contraindicated) of the patients. Charlson index (OR 1.34, 95% IC 1.02–1.76) and number of drugs prescribed during admission (OR 1.42, 95% IC 1.12–1.81) were independently associated with rDDIs. Prevalence of patients with real and pDDIs was high, especially those clinically relevant. Both comorbidities and polypharmacy were found as risk factors independently associated with DDIs development.M. D. Cantudo-CuencaAntonio Gutiérrez-PizarrayaAna Pinilla-FernándezEnrique Contreras-MacíasM. Fernández‑FuertesF. A Lao‑DomínguezPilar RincónJuan Antonio PinedaJuan MacíasRamón Morillo-VerdugoNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q M. D. Cantudo-Cuenca Antonio Gutiérrez-Pizarraya Ana Pinilla-Fernández Enrique Contreras-Macías M. Fernández‑Fuertes F. A Lao‑Domínguez Pilar Rincón Juan Antonio Pineda Juan Macías Ramón Morillo-Verdugo Drug–drug interactions between treatment specific pharmacotherapy and concomitant medication in patients with COVID-19 in the first wave in Spain
description	Abstract Primary aim was to assess prevalence and severity of potential and real drug–drug interactions (DDIs) among therapies for COVID-19 and concomitant medications in hospitalized patients with confirmed SARS-CoV-2 infection. The secondary aim was to analyze factors associated with rDDIs. An observational single center cohort study conducted at a tertiary hospital in Spain from March 1st to April 30th. rDDIs refer to interaction with concomitant drugs prescribed during hospital stay whereas potential DDIs (pDDIs) refer to those with domiciliary medication. DDIs checked with The University of Liverpool resource. Concomitant medications were categorized according to the Anatomical Therapeutic Chemical classification system. Binomial logistic regression was carried out to identify factors associated with rDDIs. A total of 174 patients were analyzed. DDIs were detected in 152 patients (87.4%) with a total of 417 rDDIs between COVID19-related drugs and involved hospital concomitant medication (60 different drugs) while pDDIs were detected in 105 patients (72.9%) with a total of 553 pDDIs. From all 417 rDDIs, 43.2% (n = 180) were associated with lopinavir/ritonavir and 52.9% (n = 221) with hydroxychloroquine, both of them the most prescribed (106 and 165 patients, respectively). The main mechanism of interaction observed was QTc prolongation. Clinically relevant rDDIs were identified among 81.1% (n = 338) (‘potential interactions’) and 14.6% (n = 61) (contraindicated) of the patients. Charlson index (OR 1.34, 95% IC 1.02–1.76) and number of drugs prescribed during admission (OR 1.42, 95% IC 1.12–1.81) were independently associated with rDDIs. Prevalence of patients with real and pDDIs was high, especially those clinically relevant. Both comorbidities and polypharmacy were found as risk factors independently associated with DDIs development.
format	article
author	M. D. Cantudo-Cuenca Antonio Gutiérrez-Pizarraya Ana Pinilla-Fernández Enrique Contreras-Macías M. Fernández‑Fuertes F. A Lao‑Domínguez Pilar Rincón Juan Antonio Pineda Juan Macías Ramón Morillo-Verdugo
author_facet	M. D. Cantudo-Cuenca Antonio Gutiérrez-Pizarraya Ana Pinilla-Fernández Enrique Contreras-Macías M. Fernández‑Fuertes F. A Lao‑Domínguez Pilar Rincón Juan Antonio Pineda Juan Macías Ramón Morillo-Verdugo
author_sort	M. D. Cantudo-Cuenca
title	Drug–drug interactions between treatment specific pharmacotherapy and concomitant medication in patients with COVID-19 in the first wave in Spain
title_short	Drug–drug interactions between treatment specific pharmacotherapy and concomitant medication in patients with COVID-19 in the first wave in Spain
title_full	Drug–drug interactions between treatment specific pharmacotherapy and concomitant medication in patients with COVID-19 in the first wave in Spain
title_fullStr	Drug–drug interactions between treatment specific pharmacotherapy and concomitant medication in patients with COVID-19 in the first wave in Spain
title_full_unstemmed	Drug–drug interactions between treatment specific pharmacotherapy and concomitant medication in patients with COVID-19 in the first wave in Spain
title_sort	drug–drug interactions between treatment specific pharmacotherapy and concomitant medication in patients with covid-19 in the first wave in spain
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/b63d4137a2064352b56e7152c9097cb1
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Drug–drug interactions between treatment specific pharmacotherapy and concomitant medication in patients with COVID-19 in the first wave in Spain

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