Thiruchelvam Theeba, Lim Chiao Xin, Munro Courtney, Chan Vincent, Jayasuria Geshani, Coulthard Kingsley P, Wark Peter A B, Suppiah Vijayaprakash
Discipline of Pharmacy, School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC 3083, Australia.
John Hunter Hospital, Newcastle, NSW 2305, Australia.
Life (Basel). 2025 Aug 7;15(8):1256. doi: 10.3390/life15081256.
People with cystic fibrosis may experience polypharmacy, which can increase the risk of drug induced complications such as adverse events and drug-drug interactions. This study aimed to examine the prevalence of adverse events and to identify potential drug-drug interactions associated with elexacaftor/tezacaftor/ivacaftor (ETI). Three databases, the Australian Therapeutic Goods Administration Database of Adverse Event Notification (TGA DAEN), the Canada Vigilance Adverse Reaction Online Database (CVAROD), and the USA Food and Drug Administration Adverse Event Reporting System (FAERS) Database were searched for spontaneous ETI adverse events between 2019 and 2024. Descriptive analysis of the data was undertaken. The FAERS database was analysed to identify adverse events of interest such as anxiety and depression and concomitant drugs prescribed with ETI. A total of 10,628 ETI associated adverse events were identified in all system organ classes. The incidence of psychiatric adverse events ranged from 7 to 15% across the three databases. Potential drug-drug interactions with CYP 3A4/5 strong inhibitors and strong inducers were identified from the FAERS database and azole antifungals were implicated in several ETI dose modifications. The prevalence and types of ETI adverse events were varied and use of concomitant drugs with potential drug interactions was significant, requiring more research to manage them.
患有囊性纤维化的人可能会使用多种药物,这会增加药物引起的并发症风险,如不良事件和药物相互作用。本研究旨在调查不良事件的发生率,并确定与依列卡福/替扎卡福/依伐卡福(ETI)相关的潜在药物相互作用。检索了三个数据库,即澳大利亚治疗用品管理局不良事件通报数据库(TGA DAEN)、加拿大警戒不良反应在线数据库(CVAROD)和美国食品药品监督管理局不良事件报告系统(FAERS)数据库,以查找2019年至2024年期间ETI的自发不良事件。对数据进行了描述性分析。对FAERS数据库进行分析,以确定感兴趣的不良事件,如焦虑和抑郁,以及与ETI同时开具的药物。在所有系统器官类别中,共识别出10628例与ETI相关的不良事件。三个数据库中精神科不良事件的发生率在7%至15%之间。从FAERS数据库中识别出与CYP 3A4/5强抑制剂和强诱导剂的潜在药物相互作用,并且唑类抗真菌药物与几种ETI剂量调整有关。ETI不良事件的发生率和类型各不相同,同时使用具有潜在药物相互作用的药物的情况很显著,需要更多研究来管理这些情况。