Guzmán Cordero Carlos, Sáez-Torres de Vicente María, Jiménez Espinosa Álvaro, Gago Sánchez Ana Isabel
Pharmacy Department, Reina Sofía University Hospital / Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC) / University of Córdoba, Córdoba, Spain.
Pharmacy Department, University Clinical Hospital, Valencia, Spain.
J Oncol Pharm Pract. 2025 Apr;31(3):374-380. doi: 10.1177/10781552241237750. Epub 2024 Mar 7.
ObjectiveNew drugs developed for SARS-CoV-2 infection, such as nirmatrelvir/ritonavir (NMV/r), represent a potential for oncohematology patients, but also pose a challenge in managing the potential clinically relevant drug-drug interactions (pDDIs) that may arise. The aim of this study is to assess the frequency, severity, and pharmacist detection of pDDIs.MethodsThis prospective, observational, study spanned 8 months, involving 42 oncohematology patients prescribed NMV/r in a tertiary-level hospital. A Board Certified oncology pharmacist assessed pDDIs using three databases and made recommendations to prescribing physicians. Linear and logistic regression analyses were employed to explore the relationship between prescribed drugs and pDDIs.ResultsClinically relevant pDDIs were detected in 76.2% of patients, with 18.1% of all medications involved in drug-drug interactions (DDIs). The most common drugs implicated were atorvastatin and imatinib. Micromedex® identified 63.3% of interactions as major severity, while Lexicomp® and University of Liverpool classifications were less restrictive. Pharmacists prevented most DDIs from reaching patients through different interventions, including treatment monitoring (44.2%), discontinuation (36.5%), and dose reduction (17.3%).ConclusionThis study highlights the high prevalence of clinically significant pDDIs in oncohematology patients receiving NMV/r for COVID-19. Pharmacists, as integral members of the healthcare team, played a crucial role in detecting, categorizing, and mitigating these interactions. The results underscore the need for comprehensive studies to evaluate the impact of pharmacist-led interventions in optimizing drug therapy and enhancing patient safety in this vulnerable population.
目的
为治疗严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染而研发的新药，如奈玛特韦/利托那韦（NMV/r），对肿瘤血液科患者来说既是一种潜在的治疗选择，但同时也给管理可能出现的具有临床相关性的药物相互作用（pDDIs）带来了挑战。本研究旨在评估pDDIs的发生频率、严重程度以及药剂师对其的检测情况。
方法
本前瞻性观察性研究历时8个月，纳入了一家三级医院中42例接受NMV/r治疗的肿瘤血液科患者。一名获得委员会认证的肿瘤药剂师使用三个数据库评估pDDIs，并向开处方的医生提出建议。采用线性回归和逻辑回归分析来探究所开药物与pDDIs之间的关系。
结果
76.2%的患者检测到具有临床相关性的pDDIs，所有药物中有18.1%涉及药物相互作用（DDIs）。涉及的最常见药物是阿托伐他汀和伊马替尼。Micromedex®将63.3%的相互作用判定为严重程度较高，而Lexicomp®和利物浦大学的分类标准限制相对较宽松。药剂师通过不同干预措施，包括治疗监测（44.2%）、停药（36.5%）和减量（17.3%），防止了大多数DDIs影响到患者。
结论
本研究凸显了接受NMV/r治疗新冠肺炎的肿瘤血液科患者中具有临床意义的pDDIs的高发生率。药剂师作为医疗团队的重要成员，在检测、分类和减轻这些相互作用方面发挥了关键作用。研究结果强调需要进行全面研究，以评估药剂师主导的干预措施对优化该脆弱人群的药物治疗和提高患者安全性的影响。
