Analysis of drug–drug interactions among patients receiving antiretroviral regimens using data from a large open-source prescription database. (1st August 2018)

• Record Type: Journal Article
• Authors: Patel, Nimish; Borg, Peter; Haubrich, Richard; McNicholl, Ian
• Is Part Of: American journal of health-system pharmacy. Volume 75:Number 15(2019)
• Page Start: 1132
• Page End: 1139
• Publication Date: 2018-08-01
• Subjects: antiretroviral therapy -- drug interactions -- HIV -- safety; Hospital pharmacies -- United States -- Periodicals; 615.1
• DOI: 10.2146/ajhp170613
• Languages: English
• ISSNs: 1079-2082

Abstract

Abstract : Purpose: Results of a study of contraindicated concomitant medication use among recipients of preferred antiretroviral therapy (ART) regimens are reported. Methods: A retrospective study was conducted to evaluate concomitant medication use in a cohort of previously treatment-naive, human immunodeficiency virus (HIV)–infected U.S. patients prescribed preferred ART regimens during the period April 2014–March 2015. Data were obtained from a proprietary longitudinal prescription database; elements retrieved included age, sex, and prescription data. The outcome of interest was the frequency of drug–drug interactions (DDIs) associated with concomitant use of contraindicated medications. Results: Data on 25, 919 unique treatment-naive patients who used a preferred ART regimen were collected. Overall, there were 384 instances in which a contraindicated medication was dispensed for concurrent use with a recommended ART regimen. Rates of contraindicated concomitant medication use differed significantly by ART regimen; the highest rate (3.2%) was for darunavir plus ritonavir plus emtricitabine–tenofovir disoproxil fumarate (DRV plus RTV plus FTC/TDF), followed by elvitegravir–cobicistat–emtricitabine–tenofovir disoproxil fumarate (EVG/c/FTC/TDF)(2.8%). The highest frequencies of DDIs were associated with ART regimens that included a pharmacoenhancing agent: DRV plus RTV plus FTC/TDF (3.2%) and EVG/c/FTC/TDF (2.8%). Conclusion: In a large population of treatment-naive HIV-infected patients, ART regimens that contained a pharmacoenhancing agent were involved most frequently in contraindicated medication–related DDIs. All of the DDIs could have been avoided by using therapeutic alternatives within the same class not associated with a DDI.