Potential and real drug interactions in patients treated with abiraterone or enzalutamide in clinical practice

Vicente-Valor, Juan; Escudero‐Vilaplana, Vicente; Collado-Borrell, Roberto; Pérez-Ramírez, Sara; Villanueva-Bueno, Cristina; Narrillos-Moraza, Álvaro; García-Sánchez, Sebastián; Beamud-Cortés, M.; Herranz, Ana; Sanjurjo, María

doi:10.1080/17425255.2021.2027908

Cited by 9 publications

(4 citation statements)

References 21 publications

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“…The IDS varied in a wide range and after dichotomization the high IDS proved to predict a significantly longer AA treatment and OS compared to the low IDS. In case of patients treated with AA, the IDS is a mirror of DDI, which was the main subject of some reports ( Graff and Beer, 2014 ; Benoist et al, 2016 ; Jamani et al, 2016 ; Bonnet et al, 2017 ; Del Re et al, 2017 ; Dubinsky et al, 2019 ; Escudero-Vilaplana et al, 2020 ; Vicente-Valor et al, 2021 ). However, none of these studies analyzed the impact of DDI on the outcome of AA treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Four publications have retrospectively investigated the DDI in 72 ( Escudero-Vilaplana et al, 2020 ), 95 ( Bonnet et al, 2016 ), 84 ( Jamani et al, 2016 ) and 87 ( Vicente-Valor et al, 2021 ) mCRPC patients on AA treatment. They used search software of DDI databases (e.g., Lexicomp, Micromedex, etc.)…”

Section: Discussionmentioning

confidence: 99%

“…The difference between the two studies may be due to the fact that the above study only included drugs used before AA treatment. In a study about AA and enzalutamide ( Vicente-Valor et al, 2021 ), tamsulosin (17%), tramadol (9%), duloxetine (6%) were the most likely involved medicines in possible DDI with AA. The occurrence of tamsulosin and tramadol in our case has been described above, while the frequency of duloxetine was 1%.…”

Section: Discussionmentioning

confidence: 99%

“…One study ( Benoist et al, 2018 ) strongly recommended to replace carbamazepine (DS = −5) during AA treatment. In addition, among the other drugs with negative DS, insulin (−3) and spironolactone (−1) have also been shown to impair the efficacy of AA treatment ( Serrano Domingo et al, 2021 ; Vicente-Valor et al, 2021 ). The positive effect present in our study of frequently used drugs with positive DS, like vitamin D (5) and pantoprazole (5), which is a proton pump inhibitor (PPI), should be emphasized.…”

Section: Discussionmentioning

confidence: 99%

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A new method to quantify the effect of co-medication on the efficacy of abiraterone in metastatic castration-resistant prostate cancer patients

Fekete,

Bársony,

Biró

et al. 2023

Front. Pharmacol.

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Background and Objective: Patients with metastatic castration-resistant prostate cancer (mCRPC) treated with abiraterone acetate (AA) have co-morbidities treated with different drugs. The aim was to quantify the potential effect of co-medications on AA treatment duration (TD) and overall survival (OS).Methods: A new parameter, called “individual drug score” (IDS) was calculated by summing the “drug score”-s (DS) of all co-medications for each patient. The DS was determined by quantifying the effect of a given co-drug on enzymes involved in steroidogenesis and metabolism of AA. The correlation between log (IDS) and TD was tested by non-linear curve fit. Kaplan-Meier method and multivariate Cox regression was used for analysis of TD and OS.Results: The IDS and TD of AA+prednisolone showed a dose-response correlation (n = 166). Patients with high IDS had significantly longer TD and OS (p <0.001). In multivariate analysis IDS proved to be an independent marker of TD and OS. The same analysis was performed in a separate group of 81 patients receiving AA+dexamethasone treatment. The previously observed relationships were observed again between IDS and TD or OS. After combining the AA+prednisolone and AA+dexamethasone groups, analysis of the IDS composition showed that patients in the high IDS group not only used more drugs (p <0.001), but their drugs also had a higher mean DS (p = 0.001).Conclusion: The more co-drugs with high DS, the longer the duration of AA treatment and OS, emphasizing the need for careful co-medication planning in patients with mCRPC treated with AA. It is recommended that, where possible, co-medication should be modified to minimize the number of drugs with negative DS and increase the number of drugs with high DS. Our new model can presumably be adapted to other drugs and other cancer types (or other diseases).

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