Department of Neurology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.
Department of Pharmacology and Toxicology, Faculty of Medical Sciences, University of Kragujevac, Kragujevac, Serbia.
Neurol Res. 2021 Dec;43(12):1023-1030. doi: 10.1080/01616412.2021.1948767. Epub 2021 Jul 7.
Our aim was to determine risk factors for and frequency of potential drug-drug interactions (pDDIs) among hospitalized patients with myasthenia gravis (MG).
This was a retrospective cross-sectional study of the-first time hospitalized MG patients or patients hospitalized because of the exacerbation of MG at the Neurology Clinic of the Clinical Center of Serbia, Belgrade. Medical records and discharge summaries of hospitalized MG patients over a 10-year period were reviewed. The pDDIs were identified by means of Micromedex, and multivariate regression methods were used to reveal potential predictors of number of pDDIs per patient.
The study included 687 patients with MG. In total, 2041 pDDIs were detected in 608 (88.5%) patients. Among the discovered pDDIs, 329 different pDDIs were observed. The most frequent pDDIs were pyridostigmine-prednisone (487patients/70.9%) and aspirin-prednisone (90 patients/13.1%) classified as moderate, and enalapril-potassium chloride (71patients/10.3%) classified as major pDDI. Five drugs (aspirin, insulin, prednisone, cyclosporine, metformin) were responsible for 22.6% of different pDDIs. Dyspnea, generalized form of MG, diabetes mellitus, hypertension, total number of drugs-used, use of antiplatelets were identified as the relevant risk factors for total number of pDDIs (R2 = 0.626,F = 73.797, p < 0.001), while age of patients and history of cancer were inversely correlated with such an outcome.
The frequency of the pDDIs in hospitalized MG patients is high, and adversely influenced by dyspnea, generalized MG, diabetes mellitus, hypertension, total number of drugs-used and use of antiplatelets.
本研究旨在确定住院重症肌无力（MG）患者发生潜在药物相互作用（pDDI）的风险因素和频率。
这是一项回顾性横断面研究，纳入了塞尔维亚临床中心神经病学诊所首次住院的 MG 患者或因 MG 加重而住院的患者。回顾性分析了 10 年间住院 MG 患者的病历和出院记录。通过 Micromedex 确定 pDDI，采用多元回归方法揭示每位患者发生 pDDI 的潜在预测因素。
本研究共纳入 687 例 MG 患者。共发现 608 例（88.5%）患者存在 2041 种 pDDI。在发现的 pDDI 中，观察到 329 种不同的 pDDI。最常见的 pDDI 为吡啶斯的明-泼尼松（487 例/70.9%）和阿司匹林-泼尼松（90 例/13.1%），均为中度 pDDI，依那普利-氯化钾（71 例/10.3%）为重度 pDDI。有 5 种药物（阿司匹林、胰岛素、泼尼松、环孢素、二甲双胍）导致了 22.6%的不同 pDDI。呼吸困难、MG 全身型、糖尿病、高血压、使用药物总数、抗血小板药物的使用被确定为 pDDI 总数的相关危险因素（R2=0.626，F=73.797，p<0.001），而患者年龄和癌症史与这一结果呈负相关。
住院 MG 患者 pDDI 的发生频率较高，与呼吸困难、MG 全身型、糖尿病、高血压、使用药物总数和抗血小板药物的使用呈负相关。
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