Frahm Niklas, Hecker Michael, Langhorst Silvan Elias, Mashhadiakbar Pegah, Haker Marie-Celine, Zettl Uwe Klaus
Department of Neurology, Neuroimmunology Section, University of Rostock, Gehlsheimer Str. 20, Rostock, 18147, Germany.
Department of Neurology, Neuroimmunology Section, University of Rostock, Rostock, Germany.
Ther Adv Neurol Disord. 2020 Dec 19;13:1756286420969501. doi: 10.1177/1756286420969501. eCollection 2020.
Multiple sclerosis (MS) is the most common neuroimmunological disease of the central nervous system in young adults. Despite recommended contraception, unplanned pregnancies can occur in women of childbearing age with MS. MS- and comorbidities-related multimedication in these patients represents a potential risk. We aimed to raise awareness regarding the frequency of polypharmacy and drug-drug interactions (DDIs) in female MS patients of childbearing age.
Sociodemographic, clinical and pharmaceutical data were collected through patient records, clinical investigations and structured patient interviews of 131 women with MS. The clinical decision support software MediQ was used to identify potential DDIs. A medication and DDI profile of the study population was created by statistical analysis of the recorded data.
Of the 131 female MS patients, 41.2% were affected by polypharmacy (concurrent use of ⩾5 drugs). Polypharmacy was associated with higher age, higher degree of disability, chronic progressive MS disease course and comorbidities. With an average intake of 4.2 drugs per patient, a total of 1033 potential DDIs were identified. Clinically relevant DDIs were significantly more frequent in patients with polypharmacy than in patients without polypharmacy (31.5% 5.2%; Fisher's exact test: < 0.001).
For the first time, a comprehensive range of potential DDIs in women of childbearing age with MS is presented. Polypharmacy is associated with the occurrence of clinically relevant DDIs. This shows the need for effective and regular screening for such interactions in order to prevent avoidable adverse effects.
多发性硬化症（MS）是年轻成年人中最常见的中枢神经系统神经免疫疾病。尽管有推荐的避孕措施，但育龄期MS女性仍可能发生意外怀孕。这些患者中与MS及合并症相关的多种药物治疗存在潜在风险。我们旨在提高对育龄期女性MS患者多重用药及药物相互作用（DDIs）发生率的认识。
通过患者记录、临床检查以及对131例MS女性患者进行结构化访谈收集社会人口统计学、临床和药学数据。使用临床决策支持软件MediQ识别潜在的DDIs。通过对记录数据的统计分析创建研究人群的用药和DDI概况。
131例女性MS患者中，41.2%受多重用药影响（同时使用≥5种药物）。多重用药与年龄较大、残疾程度较高、慢性进展性MS病程及合并症相关。每位患者平均服用4.2种药物，共识别出1033种潜在的DDIs。多重用药患者中临床相关DDIs的发生率显著高于非多重用药患者（31.5%对5.2%；Fisher精确检验：P<0.001）。
首次全面呈现了育龄期MS女性患者潜在DDIs的范围。多重用药与临床相关DDIs的发生有关。这表明需要进行有效且定期的此类相互作用筛查，以预防可避免的不良反应。
