(61) Assessment of Drug-Drug Interactions and Their Associated Risk Factors in Patients with Systemic Lupus Erythematosus: A Cross-Sectional Study

Friday, August 26, 2022

8:00 AM – 6:00 PM CEST

Location: Hall C

Publication Number: 392

Presenting Author(s)

Sujit Kumar Sah, Snr., PhD
– Research Scholar, Dept. of Pharmacy Practice, JSS College of Pharmacy, JSS AHER, Mysuru-570015 and Dept. of Pharmacy Practice, School of Health Science & Technology, Dr. Vishwanath Karad MIT World Peace University, Pune-411038, India, Mysuru, Karnataka, India

Co-Author(s)

Subramanian Ramaswamy
– Associate Professor & Head, Department of Rheumatology & Immunology, JSS Medical Collage & Hospital, JSS Academy of Higher Education & Research, SS Nagar, Mysuru-570015, Karnataka, India, Mysore, Karnataka, India
Ramesh Madhan, PhD
– Professor, JSS College of Pharmacy, Mysore, India

Background: The pharmacotherapy management of systemic lupus erythematosus (SLE) is rather challenging due to high disease activity and requires complex treatment regimens. The presence of complex drug regimens and polypharmacy is associated with a high risk of potential drug-drug interactions (pDDIs).

Objectives: To determine the prevalence, severity and associated risk factors of potential drug-drug interactions among SLE patients.

Methods: A cross-sectional study was conducted at the department of rheumatology in a teaching hospital in Sothern India for 24 months. Patients of any gender and aged ≥ 16 years, who were diagnosed with SLE and admitted to hospital or visited outpatient rheumatology department were included in this study. Clinical pharmacist has been reviewed patients' treatment charts prospectively on daily basis to identify pDDIs using IBM Micromedex® drug interaction checker. Identified pDDIs were classified into contraindicated, major, moderate, and minor. Logistic regression analysis was used to identify the risk factors associated with pDDIs (major and/or moderate).

Results: A total of 202 patients’ prescriptions were reviewed to assess the pDDIs. Of them, 179/202 (88.6%) patients were presented with ≥1 pDDIs. Overall, 502 pDDIs were identified among 338 pairs of drugs with an average frequency of 2.8 pDDIs per patient. Of 502 pDDIs, (n=40, 7.9%) were contraindicated, (n=161, 32.1%) were major, (n=252, 50.2%) were moderate and (n=49, 9.8%) were minor pDDIs. The most commonly involved drug pair of pDDIs was prednisolone and aceclofenac (13.46%) which increase the likelihood of gastrointestinal ulcer or bleeding. Of them, 5.8% pDDIs were actual which resulted in adverse events. Patients taking ≥5 medications [OR: 9.52, 95% CI (3.7-28.44), p< 0.0001) and presented with ≥3 comorbidities [OR: 8.42, 95% CI (2.44-18.17), p< 0.0001] were at high risk for pDDIs (major and/or moderate).

Conclusions: The prevalence of pDDIs was high among systemic lupus erythematosus patients. Pharmacists and prescribers need to pay attention to evaluating the pDDIs in high-risk patients to avoid pDDIs related adverse events and complications.