Assessing the proportion of the Danish population at risk of clinically significant drug-drug interactions with new oral antivirals for early treatment of COVID-19

Larsen, Carsten Schade

doi:10.1016/j.ijid.2022.06.059

Cited by 11 publications

(4 citation statements)

References 15 publications

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“…Our work extends other assessments of the risk of potential nirmatrelvir/ritonavir DDIs, which arise from the rapid and potent inhibition effect of ritonavir instead of induction effect 9 . For example, in an analysis of national prescription data from Denmark, the authors estimated the proportion of older adults at risk of DDIs with nirmatrelvir/ritonavir ranged from 0.7% to 32% across age and interacting drug groups 20 . In another assessment that theoretically exposed the trial cohort which included older, hospitalized adults with polypharmacy to nirmatrelvir/ritonavir, more than two‐thirds of individuals (68%) were subject to potential DDIs with nirmatrelvir/ritonavir 21 .…”

Section: Discussionmentioning

confidence: 64%

“…9 For example, in an analysis of national prescription data from Denmark, the authors estimated the proportion of older adults at risk of DDIs with nirmatrelvir/ritonavir ranged from 0.7% to 32% across age and interacting drug groups. 20 In another assessment that theoretically exposed the trial cohort which included older, hospitalized adults with polypharmacy to nirmatrelvir/ritonavir, more than two-thirds of individuals (68%) were subject to potential DDIs with nirmatrelvir/ritonavir. 21 Since both studies reported the proportion of interacting drugs among all older people rather than real nirmatrelvir/ritonavir users to evaluate the prevalence of potential DDIs involving nirmatrelvir/ ritonavir, the prevalence was likely underestimated.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Potential drug–drug interactions among U.S. adults treated with nirmatrelvir/ritonavir: A cross‐sectional study of the National Covid Cohort Collaborative (N3C)

et al. 2023

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ImportanceNirmatrelvir/ritonavir has potential to interact with many drugs.ObjectiveTo estimate the prevalence of potential moderate to severe drug‐drug interactions (DDIs) involving nirmatrelvir/ritonavir, identify interacting medications, and evaluate risk factors associated with potential DDIs.Design, Setting, and ParticipantsCross‐sectional study using electronic health records from the National COVID Cohort Collaborative Enclave, one of the largest COVID‐19 data resources in the United States. Study participants were outpatients aged ≥18 years and started nirmatrelvir/ritonavir between December 23, 2021 and March 31, 2022.Main Outcome and MeasuresPotential moderate to severe DDIs, defined as starting interacting medications reported by National Institutes of Health 30 days before or 10 days after starting nirmatrelvir/ritonavir.ResultsOf 3214 outpatients who started nirmatrelvir/ritonavir, the mean age was 56.8±17.1 years, 39.5% were male, and 65.8% were non‐Hispanic white. Overall, 521 (16.2%) were potentially exposed to at least one moderate to severe DDI, most commonly to atorvastatin (19.2% of all DDIs), hydrocodone (14.0%), or oxycodone (14.0%). After adjustment for covariates, potential DDIs were more likely among individuals who were older (odds ratio [OR] 1.16 per 10‐year increase, 95% confidence interval [CI] 1.08‐1.25), male (OR 1.36, CI 1.09‐1.71), smokers (OR 1.38, CI 1.10‐1.73), on more co‐medications (OR 1.35, CI 1.31‐1.39), and with a history of solid organ transplant (OR 3.63, CI 2.05‐6.45).Conclusions and RelevanceOne in six of individuals receiving nirmatrelvir/ritonavir were at risk of a potential moderate or severe DDI, underscoring the importance of clinical and pharmacy systems to mitigate such risks.

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Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 99%

Potential drug–drug interactions among U.S. adults treated with nirmatrelvir/ritonavir: A cross‐sectional study of the National Covid Cohort Collaborative (N3C)

et al. 2023

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“…Concluyen que el riesgo de interacciones farmacológicas relevantes se relacionan con las características de la población, ya que el 20% de pacientes mayores de 65 años y el 30% de pacientes mayores de 80 estaban en tratamiento con anticoagulantes orales, y un 15-18% de la población con estatinas, por lo que las potenciales interacciones con nirmatrelvir/ritonavir podían ser frecuentes. Por otra parte, concluyeron que el antiviral interacciona con otros fármacos de uso habitual como analgésicos, bloqueantes de canales de calcio o digoxina, lo que sugiere la importancia de la revisión del tratamiento de los pacientes previo a su uso, especialmente en personas mayores 11 .…”

Section: Discussionunclassified

Nirmatrelvir/ritonavir drug-drug interactions in primary care outpatients

Rodríguez Esquíroz,

Sanz Álvarez,

Marín Marín

et al. 2023

An Sist Sanit Navar

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Resumen Fundamento Nirmatrelvir/ritonavir es un antiviral oral con un alto potencial de producir interacciones farmacológicas. La población candidata a recibirlo es mayoritariamente vulnerable, con enfermedades crónicas y polimedicada. El objetivo es evaluar la validación farmacéutica previa a la administración del antiviral. Material y métodos Las interacciones farmacológicas entre nirmatrelvir/ritonavir y el tratamiento habitual se consultaron en fichas técnicas y las herramientas de interacciones de UpToDate® y Universidad de Liverpool®. Se incluyeron las prescripciones validadas por un farmacéutico de atención primaria (abril/2022-abril/2023). Resultados Se incluyeron 159 pacientes; en 83 se detectaron 168 interacciones que podían suponer un cambio en su tratamiento. Las estatinas (25,6%), anticoagulantes (10,7%) y antihipertensivos (10,7%) fueron los grupos terapéuticos más frecuentemente implicados. La suspensión (53,0%) y reducción de dosis (22,6%) fueron los cambios de tratamiento más frecuentes. Conclusiones La revisión de potenciales interacciones farmacológicas, los ajustes posológicos y las modificaciones del tratamiento habitual del paciente han evitado potenciales toxicidades, mejorando la seguridad de nirmatrelvir/ritonavir.

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“…The use of nirmatrelvir-ritonavir is also challenged by drug–drug interactions. Some studies figured out that 12–20% of at-risk populations had potential severe drug–drug interactions or required to change chronic treatments when treated with nirmatrelvir-ritonavir [ 6 , 23 ].…”

Section: Treatment Of Mild-to-moderate Covid-19 Disease In the Outpat...mentioning

confidence: 99%

Drug treatment of COVID-19 infection

Lui

Guaraldi

2023

Current Opinion in Pulmonary Medicine

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Purpose of reviewCOVID-19 pandemic has caused more than 6.6 million deaths globally. Tremendous efforts have been committed for the development of new and repurposed drugs for the treatment of COVID-19. Although different international and national guidelines share consensus in the management of COVID-19 disease with different levels of severity, new challenges have emerged, steering the need for ongoing research in advancing the clinical management of COVID-19.Recent findingsThis review focuses on recent data from randomized trials and postmarketing real-world evidence for the treatment of mild to moderate disease in the outpatient setting and patients hospitalized for COVID-19 with varying level of severity. Relevant data for treatment of the latest omicron sub-variants in people who received vaccination are presented. Challenges in special populations, including immunocompromised hosts, patients with renal failure and pregnant women, are also discussed.SummaryTreatment of COVID-19 should be personalized according to host characteristics, degree of severity and available treatment options.

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Assessing the proportion of the Danish population at risk of clinically significant drug-drug interactions with new oral antivirals for early treatment of COVID-19

Cited by 11 publications

References 15 publications

Potential drug–drug interactions among U.S. adults treated with nirmatrelvir/ritonavir: A cross‐sectional study of the National Covid Cohort Collaborative (N3C)

Potential drug–drug interactions among U.S. adults treated with nirmatrelvir/ritonavir: A cross‐sectional study of the National Covid Cohort Collaborative (N3C)

Nirmatrelvir/ritonavir drug-drug interactions in primary care outpatients

Drug treatment of COVID-19 infection

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