S967 Real-World Prevalence of Potential Drug-Drug Interactions Associated With Oral Advanced Therapies Indicated for Ulcerative Colitis
Notice bibliographique
Résumé
Introduction: Presence of comorbidities and polypharmacy among patients with ulcerative colitis (UC) poses a risk of drug-drug interactions (DDIs). This study aimed to describe the prevalence of potential DDIs associated with oral advanced therapies among patients with UC. Methods: Adults with UC were selected from the Merative™ MarketScan® Commercial Database (01/01/2018-01/31/2023); the index date was the most recent UC diagnosis. Patients had no other immune conditions in the 12-month baseline period before the index date. A subgroup with moderate-to-severe UC (≥1 UC-related surgery or hospitalization, biologic, advanced therapy, immunomodulator, or continuous corticosteroid use for ≥90 days during baseline period) was analyzed separately. Potential DDIs were identified as claims for medications that may cause a moderate or severe DDI with ozanimod or Janus kinase (JAK) inhibitors (tofacitinib/upadacitinib) according to the Merative™ Micromedex® Complete Drug Interactions Tool. Potential DDIs were described during the 12 months before the index date. Results: Of 58,870 patients with UC, 24,654 (41.9%) had moderate-to-severe UC (Table 1). All potential DDIs with ozanimod were severe, while JAK inhibitors had both moderate and severe potential DDIs (Figure 1). Among patients with UC, mean [standard deviation] number of severe DDIs was 2.0 [2.4] for ozanimod and 0.2 [0.5] for JAK inhibitors; in moderate-to-severe UC, it was 2.3 [2.6] for ozanimod and 0.4 [0.6] for JAK inhibitors. The most common agents potentially causing DDIs for ozanimod in UC and moderate-to-severe UC were ondansetron (18.6% and 22.7%), azithromycin (11.9% and 12.8%), as well as hydrocodone, fentanyl, albuterol, ciprofloxacin, and metronidazole (9.0%-11.0% each). For JAK inhibitors, these were COVID-19 vaccines (30.7% and 31.4%), infliximab (8.5% and 20.2%), fluconazole (6.1% and 6.8%), and azathioprine (5.5% and 13.0%). Conclusion: In this descriptive analysis of patients with UC and moderate-to-severe UC, the prevalence of potential DDIs was higher for ozanimod than for JAK inhibitors. Commonly used medications with a potential to interact with oral advanced therapies were for nausea, pain, and infection management, which are common UC-related comorbidities or symptoms. Planned analyses will focus on class-level DDIs to better understand this relationship. These findings support the need for thorough evaluation of comorbidities and medication use when prescribing new UC therapies. Funded by Janssen Scientific Affairs, LLC.Figure 1.: DDIs: drug-drug interactions; JAK: Janus kinase inhibitor; UC: ulcerative colitis. Potential for DDIs* with ozanimod and JAK inhibitors among (A) patients with UC and (B) patients with moderate-to-severe UC . *The Merative™ Micromedex® Complete Drug Interactions Tool classifies DDI severity as contraindicated for concurrent use, major (potential to be life-threatening and/or require medical intervention), and moderate (potential to exacerbate condition and/or require an alteration in therapy). “Severe” DDIs refer to contraindicated or major DDIs. Table 1. - Selected baseline demographic and clinical characteristics among patients with UC Mean ± SD [median] or n (%) Patients with UC Patients with moderate-to-severe UC N = 58,870 N = 24,654 Age at the index date 45.6 ± 13.2 [47.0] 43.8 ± 13.5 [44.0] Female 30,485 (51.8) 12,084 (49.0) Selected general comorbidities Cardiovascular disease 19,995 (34.0) 8,737 (35.4) Pain 17,218 (29.2) 8,090 (32.8) Infections 13,134 (22.3) 6,864 (27.8) Nausea and vomiting 6,402 (10.9) 3,569 (14.5) Liver disease 4,702 (8.0) 2,556 (10.4) Selected UC-related medications Any biologics/advanced therapies 15,925 (27.1) 15,925 (64.6) Anti-TNF agents 9,467 (16.1) 9,467 (38.4) Vedolizumab 5,482 (9.3) 5,482 (22.2) Ustekinumab 1,505 (2.6) 1,505 (6.1) JAK Inhibitors 1,021 (1.7) 1,021 (4.1) Ozanimod 88 (0.1) 88 (0.4) Any conventional systemic therapies 43,965 (74.7) 18,306 (74.3) Immunomodulators 5,718 (9.7) 5,718 (23.2) 5-ASA 30,986 (52.6) 10,113 (41.0) Corticosteroids 20,529 (34.9) 10,880 (44.1) 5-ASA: 5-aminosalicylic acid; JAK: Janus kinase inhibitor; SD: standard deviation; TNF: tumor necrosis factor; UC: ulcerative colitis.
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 machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,006 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,002 | 0,004 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,006 | 0,001 |
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 source (Gemma direct ou Codex distillé), 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 ».