4CPS-099 Clinically relevant drug–drug interaction events in patients with abiraterone, enzalutamide or apalutamide treatment
Notice bibliographique
Résumé
<h3>Background and importance</h3> Cytochrome P enzymes play a key role in drug metabolism and it is essential to understanding some interactions. <h3>Aim and objectives</h3> Optimising pharmacotherapy in prostate cancer patients through the identification of drug interactions between anti-androgenic therapy and the patient’s usual medication. <h3>Material and methods</h3> Patients on abiraterone, enzalutamide or apalutamide treatment were identified through the pharmacy computerised record of dispensations. Their usual medication was obtained from the pharmacotherapeutic history. The evaluation of abiraterone and enzalutamide interactions was performed with Liverpool and Uptodate databases. For apalutamide, Micromedex and Uptodate were used because apalutamide is not registered in Liverpool. Clinically relevant interactions were reported to the urologist, performing the pertinent pharmaceutical interventions. <h3>Results</h3> 32 prostate cancer patients were identified; 21 (65.6%) were treated with abiraterone, 8 (25%) with enzalutamide and 3 (9.4%) with apalutamide. The median of age was 79 (53–90) years and the median of concomitant treatments was 7 (3–13). 18 relevant interactions were detected; 2 (11.1%) with abiraterone, 10 (55.6%) with enzalutamide and 6 (33.3%) with apalutamide. The drugs with relevant interactions belonged to the following therapeutic groups: Cardiovascular system (61.1%). In the co-administration of bisoprolol with abiraterone or apalutamide we recommended reducing the bisoprolol doses. In treatments with enzalutamide and doxazosin, lecardipine, torasemide or nevibolol we advised changing the therapy to hydralazine, angiotensin-converting enzyme inhibitors, furosemide or atenolol. Statins should be replaced by ezetimibe or fibrates in enzalutamide or apalutamide treatment. Antithrombotics (16.7%). Dabigatran, apixaban or acenocoumarol are contraindicated with anti-androgenic therapy.We proposed the use of heparins or oral anticoagulants with strict international normalised ratio (INR) control. Proton pump inhibitors (PPIs) (11.1%). In patients treated with enzalutamide, pantoprazole or ??? changing to an anti-H2 was suggested. Analgesics (11.1%). Metamizole and tramadol are not recommended in cases of concomitant administration with abiraterone or apalutamide. In the consulted databases a discrepancy of 25% was found, which illustrates the need to compare at least two databases to obtain an optimal review of interactions. <h3>Conclusion and relevance</h3> Abiraterone, apalutamide and, mainly, enzalutamide suffer a large number of interactions, which may modify a treatment’s efficacy and/or its safety. The use of multiple concomitant medications is a risk factor that increases the possibility of hospitalisation and mortality. The pharmacist must achieve the correct review of drug interactions with reference to at least two databases. <h3>References and/or acknowledgements</h3> <h3>Conflict of interest</h3> No conflict of interest
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».