Identification of Drug Interaction Adverse Events in Patients With COVID-19

Conti, Valeria; Sellitto, Carmine; Torsiello, Martina; Manzo, Valentina; Bellis, Emanuela De; Stefanelli, Berenice; Bertini, Nicola; Costantino, M.; Maci, Chiara; Raschi, Emanuel; Sabbatino, Francesco; Corbi, Graziamaria; Pagliano, Pasquale; Filippelli, Amelia

doi:10.1001/jamanetworkopen.2022.7970

Cited by 33 publications

(21 citation statements)

References 46 publications

(122 reference statements)

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“…Clinically significant DDIs may result in ADRs and side effects that further impair patients’ health, obscuring the treatment outcome and prolonging hospitalization [ 16 , 17 ]. In the case of COVID-19, the scientific community gave an early warning of the risk for DDIs from the several applied protocols [ 14 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ]. Even with the introduction of nirmatrelvir/ritonavir (Paxlovid TM ), there were regulatory check lists to assist clinicians in evaluating potential DDIs and other patient factors prior to any administration [ 25 ].…”

Section: Introductionmentioning

confidence: 99%

Drug-Drug Interactions among Patients Hospitalized with COVID-19 in Greece

Spanakis

Ιωάννου

Tzalis

et al. 2022

JCM

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The modulation of the pharmacological action of drugs due to drug-drug interactions (DDIs) is a critical issue in healthcare. The aim of this study was to evaluate the prevalence and the clinical significance of potential DDIs in patients admitted to the University Hospital of Heraklion in Greece with coronavirus disease 2019 (COVID-19). Cardiovascular disorders (58.4%) and diabetes (types I and II) (29.6%) were the most common comorbidities. A high occurrence of DDIs was observed, and clinically significant DDIs that may hamper response to treatment represented 40.3% of cases on admission, 21% during hospitalization, and 40.7% upon discharge. Polypharmacy and comorbidities were associated with a higher prevalence of DDIs in a statistically significant way (p < 0.05, 95% CI). Clinically significant DDIs and increased C-reactive protein values upon admission were associated with prolonged hospitalization. The results reveal that patients admitted due to COVID-19 in Greece often have an additional burden of DDIs that healthcare teams should approach and resolve.

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Section: Introductionmentioning

confidence: 99%

Drug-Drug Interactions among Patients Hospitalized with COVID-19 in Greece

Spanakis

Ιωάννου

Tzalis

et al. 2022

JCM

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“…Baricitinib has a short half-life as compared to tocilizumab (12.5 h vs. 13 days) leading to a lesser chance of infection and long-term complications ( Cantini et al, 2020 ). Also, it has a few drug-drug interactions ( Conti et al, 2022 ). Unlike tocilizumab, baricitinib can be administered orally, can be stored easily, and is also much cheaper when used for a shorter duration.…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of baricitinib and tocilizumab in hospitalized patients with COVID-19: A comparison using systematic review and meta-analysis

et al. 2022

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Objective: This review was performed to compare the efficacy and safety among hospitalized patients with COVID-19 who received baricitinib and those who received tocilizumab independently with placebo or the standard of care (SOC).Methods: Relevant databases were searched for randomized controlled trials which evaluated the effect of baricitinib or tocilizumab as compared to placebo or the SOC in hospitalized patients with COVID-19. The primary endpoint was the comparison of the 28-day mortality. Risk ratios (RR) and mean differences were compared and pooled for dichotomous and continuous variables, respectively. A two-staged exploratory network meta-analysis using a multivariate meta-analysis was also performed. All analyses were performed in Stata version 16.0. The GRADE approach was used to assess the quality of the generated evidence (PROSPERO ID: CRD42022323363).Results: Treatment with baricitinib [RR, 0.69 (95% CI, 0.50–0.94), p = 0.02, i2 = 64.86%] but not with tocilizumab [RR, 0.87 (95% CI, 0.71–1.07), p = 0.19, i2 = 24.41%] led to a significant improvement in the 28-day mortality as compared to that with the SOC. Treatment with baricitinib or tocilizumab, both independently led to a significant reduction in the duration of hospitalization [baricitinib: mean difference, −1.13 days (95% CI, −1.51 to −0.76), p < 0.001, i2 = 0.00%; tocilizumab: mean difference, −2.80 days (95% CI, −4.17 to −1.43), p < 0.001, i2 = 55.47%] and a significant improvement in the proportion of patients recovering clinically by day 28 [baricitinib: RR, 1.24 (95% CI, 1.03–1.48), p = 0.02, i2 = 27.20%; tocilizumab: RR, 1.41 (95% CI, 1.12–1.78), p < 0.001, i2 = 34.59%] as compared to those with the SOC. From the safety point of view, both these drugs showed similar results. There were fewer patients who experienced any serious adverse event following treatment with barictinib and tocilizumab as compared to those following treatment with the SOC [baricitinib: RR, 0.76 (95% CI, 0.62–0.92), p = 0.01, i2 = 12.63%; tocilizumab: RR, 0.85 (95% CI, 0.72–1.01), p = 0.07, i2 = 0.00%].Conclusion: As baricitinib and tocilizumab are recommended interchangeably by various guidelines for the management of COVID-19, considering the better 28-day mortality data and other comparable efficacy and safety outcomes, baricitinib may be favored over tocilizumab considering its ease of administration, shorter half-life, and lower cost of treatment.

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“…Moreover, pharmacodynamic drug–drug interactions (DDIs) of CQ/HCQ with other medications must also be taken into consideration. For example, co-administration of HCQ with several antiviral agents including lopinavir-ritonavir, darunavir-cobicistat, and acetazolamide, resulted in QT-interval prolongation, ventricular arrhythmias, and torsade de pointes [ 96 ]. In addition, interference of HCQ with darunavir-cobicistat and tocilizumab might also lead to psychiatric disorders, such as behavioral disturbances, psychosis, agitation, delirium, and aggression [ 96 ].…”

Section: Antimalarial Drugsmentioning

confidence: 99%

“…For example, co-administration of HCQ with several antiviral agents including lopinavir-ritonavir, darunavir-cobicistat, and acetazolamide, resulted in QT-interval prolongation, ventricular arrhythmias, and torsade de pointes [ 96 ]. In addition, interference of HCQ with darunavir-cobicistat and tocilizumab might also lead to psychiatric disorders, such as behavioral disturbances, psychosis, agitation, delirium, and aggression [ 96 ]. Moreover, in COVID-19 patients, the administration of HCQ with acetazolamide and the anticancer ibrutinib resulted in a tachyarrhythmia as DDI [ 97 ].…”

Section: Antimalarial Drugsmentioning

confidence: 99%

Antiparasitic Drugs against SARS-CoV-2: A Comprehensive Literature Survey

et al. 2022

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More than two years have passed since the viral outbreak that led to the novel infectious respiratory disease COVID-19, caused by the SARS-CoV-2 coronavirus. Since then, the urgency for effective treatments resulted in unprecedented efforts to develop new vaccines and to accelerate the drug discovery pipeline, mainly through the repurposing of well-known compounds with broad antiviral effects. In particular, antiparasitic drugs historically used against human infections due to protozoa or helminth parasites have entered the main stage as a miracle cure in the fight against SARS-CoV-2. Despite having demonstrated promising anti-SARS-CoV-2 activities in vitro, conflicting results have made their translation into clinical practice more difficult than expected. Since many studies involving antiparasitic drugs are currently under investigation, the window of opportunity might be not closed yet. Here, we will review the (controversial) journey of these old antiparasitic drugs to combat the human infection caused by the novel coronavirus SARS-CoV-2.

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Identification of Drug Interaction Adverse Events in Patients With COVID-19

Cited by 33 publications

References 46 publications

Drug-Drug Interactions among Patients Hospitalized with COVID-19 in Greece

Drug-Drug Interactions among Patients Hospitalized with COVID-19 in Greece

Efficacy and safety of baricitinib and tocilizumab in hospitalized patients with COVID-19: A comparison using systematic review and meta-analysis

Antiparasitic Drugs against SARS-CoV-2: A Comprehensive Literature Survey

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