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类风湿关节炎管理中的多重用药与药物相互作用

Polypharmacy and drug interactions in the management of rheumatoid arthritis.

作者信息

Boeing Lorena Batista, Fogaça Natalie Sbalqueiro, Kahlow Barbara Stadler, Skare Thelma, Nisihara Renato

机构信息

Mackenzie Evangelical School of Medicine - Curitiba (PR), Brazil.

出版信息

Rev Assoc Med Bras (1992). 2025 Aug 8;71(7):e20250151. doi: 10.1590/1806-9282.20250151. eCollection 2025.

Abstract

BACKGROUND

Rheumatoid arthritis is a chronic inflammatory disease that often necessitates combination therapy. The presence of comorbidities, frequently observed in rheumatoid arthritis patients, can further increase the number of medications required, raising the risk of drug-to-drug interactions.

OBJECTIVE

This study aimed to analyze the prevalence of polypharmacy and identify potential drug-to-drug interactions in rheumatoid arthritis patients using the MedScape® digital platform.

METHODS

A retrospective analysis was conducted on 370 rheumatoid arthritis patients. Data on epidemiological characteristics, comorbidities, and the number of medications used during treatment were collected. The MedScape® platform was employed to assess potential drug-to-drug interactions.

RESULTS

Polypharmacy was observed in 81.1% of the patients, with a higher prevalence among older individuals and those with multiple comorbidities. The MedScape® platform identified 2,018 potential drug-to-drug interactions in the sample, of which 27.5% were mild, 54.4% moderate, and 17.8% severe. Severe interactions frequently involved combinations of antirheumatic drugs.

CONCLUSIONS

Polypharmacy is highly prevalent in rheumatoid arthritis treatment, particularly in patients with comorbidities, increasing the risk of clinically significant drug-to-drug interactions. Physicians should remain vigilant in monitoring for potential interactions and adopt strategies to mitigate the risks, such as regular medication reviews and utilizing digital platforms to support clinical decision-making. This approach is critical to optimizing patient safety and treatment outcomes in rheumatoid arthritis care.

摘要

背景

类风湿关节炎是一种慢性炎症性疾病,常常需要联合治疗。类风湿关节炎患者中经常观察到合并症的存在,这可能会进一步增加所需药物的数量,从而提高药物相互作用的风险。

目的

本研究旨在使用MedScape®数字平台分析类风湿关节炎患者中多重用药的患病率,并识别潜在的药物相互作用。

方法

对370例类风湿关节炎患者进行回顾性分析。收集了流行病学特征、合并症以及治疗期间使用药物数量的数据。使用MedScape®平台评估潜在的药物相互作用。

结果

81.1%的患者存在多重用药情况,在老年人和患有多种合并症的患者中患病率更高。MedScape®平台在样本中识别出2018种潜在的药物相互作用,其中27.5%为轻度,54.4%为中度,17.8%为重度。严重的相互作用经常涉及抗风湿药物的联合使用。

结论

多重用药在类风湿关节炎治疗中非常普遍,尤其是在合并症患者中,增加了具有临床意义的药物相互作用的风险。医生应保持警惕,监测潜在的相互作用,并采取策略降低风险,如定期进行药物审查和利用数字平台支持临床决策。这种方法对于优化类风湿关节炎护理中的患者安全和治疗结果至关重要。

相似文献

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Polypharmacy and drug interactions in the management of rheumatoid arthritis.类风湿关节炎管理中的多重用药与药物相互作用
Rev Assoc Med Bras (1992). 2025 Aug 8;71(7):e20250151. doi: 10.1590/1806-9282.20250151. eCollection 2025.
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本文引用的文献

1
Metabolic Consequences of Rheumatoid Arthritis.类风湿关节炎的代谢后果
Arthritis Care Res (Hoboken). 2025 Apr 2. doi: 10.1002/acr.25537.
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Polypharmacy Management in Older Patients.老年患者的多种药物治疗管理。
Mayo Clin Proc. 2021 Jan;96(1):242-256. doi: 10.1016/j.mayocp.2020.06.012.

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