Mahboobipour Amir Ali, Baniasadi Shadi
School of Medicine, Tehran University of Medical Sciences, Tehran, Iran.
Tracheal Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Drug Metab Pers Ther. 2020 Dec 21. doi: 10.1515/dmpt-2020-0145.
Coronavirus disease 2019 (COVID-19) is an emerging viral infection without any approved treatment. Investigational therapies for COVID-19 may cause clinically important drug-drug interactions (DDIs). We aimed to study potential DDIs (pDDIs) and their risk factors in COVID-19 patients admitted to the hospital.
We conducted a cross-sectional study in a tertiary respiratory hospital dedicated to COVID-19 patients. The Lexi-Interact database was used to investigate clinically important pDDIs. The database output including interacting drug pairs, risk rating, reliability rating, mechanism, and management was evaluated. Associations between the occurrence of pDDIs and probable risk factors were assessed by logistic regression analysis.
Medical charts of 227 patients were reviewed. About 38% of the patients had at least one clinically important pDDI. More than half of the interactions were between protease inhibitors (lopinavir/ritonavir) and regularly prescribed medications for the management of comorbidities or COVID-19 symptoms (e.g., atorvastatin, alprazolam, salmeterol, and tamsulosin). Ischemic heart disease, chronic respiratory diseases, and ICU admission were significantly associated with the occurrence of pDDIs.
We recommend considering the risk factors for the emergence of clinically important DDIs in the pharmacotherapy of COVID-19 patients. Using an alternative medication or dose adjustments may be required in high-risk patients.
2019冠状病毒病（COVID-19）是一种新出现的病毒感染，尚无任何获批的治疗方法。用于COVID-19的试验性疗法可能会导致具有临床重要意义的药物相互作用（DDIs）。我们旨在研究住院COVID-19患者中的潜在药物相互作用（pDDIs）及其危险因素。
我们在一家专门收治COVID-19患者的三级呼吸医院进行了一项横断面研究。使用Lexi-Interact数据库调查具有临床重要意义的pDDIs。对数据库输出结果进行评估，包括相互作用的药物对、风险评级、可靠性评级、作用机制和管理措施。通过逻辑回归分析评估pDDIs的发生与可能的危险因素之间的关联。
对227例患者的病历进行了审查。约38%的患者至少有一项具有临床重要意义的pDDI。超过一半的相互作用发生在蛋白酶抑制剂（洛匹那韦/利托那韦）与用于治疗合并症或COVID-19症状的常规处方药（如阿托伐他汀、阿普唑仑、沙美特罗和坦索罗辛）之间。缺血性心脏病、慢性呼吸道疾病和入住重症监护病房与pDDIs的发生显著相关。
我们建议在COVID-19患者的药物治疗中考虑具有临床重要意义的药物相互作用出现的危险因素。高危患者可能需要使用替代药物或调整剂量。
