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Please use this identifier to cite or link to this item: http://hdl.handle.net/1942/24454

Title: Prevalence of drug-drug interactions in the era of HIV integrase inhibitors: a retrospective clinical study
Authors: Baecke, C.
Gyssens, Inge C.
Decoutere, L.
van der Hilst, Jeroen C.
Messiaen, Peter
Issue Date: 2017
Publisher: VAN ZUIDEN COMMUNICATIONS
Citation: NETHERLANDS JOURNAL OF MEDICINE, 75(6), p. 235-240
Abstract: Background: Antiretroviral agents pose a high risk for drug-drug interactions (DDIs), mainly but not limited to being a substrate, inducer or inhibitor of P450 cytochrome enzymes. In part metabolised by other pathways, integrase inhibitors might show a more favourable profile. The aim of this study was to investigate the prevalence of DDIs in daily clinical practice for patients starting different antiretroviral treatment (ART) regimens. Methods: All patients starting ART in our centre from January 2009 to April 2016 were included. All prescribed co-medications since the start of ART were recorded retrospectively from the medical files and screened for DDIs using the Liverpool HIV drug interaction database. Only DDIs between antiretroviral and non-antiretroviral drugs were considered. Results: We included 145 patients, of which 42% were on an integrase inhibitor-based regimen, mainly dolutegravir and elvitegravir. Of the patients, 78% (n = 113) took co-medication. Potential DDIs were seen in 63% of the patients with co-medication; contraindicated prescriptions were detected in 1%. Protease inhibitor-based ART was a risk factor for DDI (odds ratio (OR) 2.57; 95% confidence interval (CI) 1.06-6.19), in contrast to non-nucleoside reverse transcriptase inhibitor-based ART (OR 0.77; 95% CI 0.32-1.84). Concerning integrase inhibitors, a significantly lower risk was seen with dolutegravir-based treatment (OR 0.35; 95% CI 0.15-0.82), though not for elvitegravir-based ART (OR 2.51; 95% CI 0.66-9.58). Conclusions: ART regimens pose a dissimilar risk for drug-drug interactions in clinical practice. Regarding the use of integrase inhibitors, a significantly lower risk was seen with dolutegravir-based treatment.
Notes: [Baecke, C.; Gyssens, I. C.; van der Hilst, J. C. H.; Messiaen, P.] Jessa Hosp, Dept Infect Dis & Immun, Hasselt, Belgium. [Gyssens, I. C.; van der Hilst, J. C. H.; Messiaen, P.] Hasselt Univ, BIOMED Res Inst, Hasselt, Belgium. [Gyssens, I. C.] Radboud Univ Nijmegen, Dept Internal Med, Med Ctr, Nijmegen, Netherlands. [Decoutere, L.] Jessa Hosp, Dept Clin Pharm, Hasselt, Belgium.
URI: http://hdl.handle.net/1942/24454
Link to publication: http://www.njmonline.nl/getpdf.php?id=1869
ISI #: 000408099500003
ISSN: 0300-2977
Category: A1
Type: Journal Contribution
Appears in Collections: Research publications

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