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Clinical Outcomes Associated with Drug-Drug Interactions of Oral Chemotherapeutic Agents: A Comprehensive Evidence-Based Literature Review

机译：口服化学治疗剂药物 - 药物相互作用相关的临床结果：全面的循证文献综述

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摘要

BackgroundOral chemotherapy use is increasing due to new drug approvals as well as the convenience of the administration of oral drugs. This increased use also raises concern regarding drug-drug interactions (DDIs) with concomitantly administered drugs, resulting in loss of therapeutic effect, decreased tolerability, and/or increased toxicity.ObjectiveThe objective of this study was to review existing evidence of the clinical impact of DDIs with oral chemotherapeutic agents.MethodsA comprehensive search of literature using PubMed was conducted in April 2018 for studies of DDIs associated with oral chemotherapy. Included studies were in English. We included randomized clinical trials, observational studies, and case reports evaluating a DDI between any oral chemotherapy drug and any other drug. Included studies needed to have at least one outcome of clinical relevance potentially attributed to the DDI, for example, effects on survival or toxicity. The quality of the articles was determined using published metrics appropriate for the study design.ResultsThere were 2626 studies identified in the initial search, of which 35 met all eligibility criteria. These included 15 retrospective cohort studies, 16 case reports or case series and four post hoc analyses of clinical trials. Among these, DDIs contributed to a statistically significant change in a clinical outcome in 12 studies. Eight of these studies evaluated overall survival and progression-free survival and found that the presence of the DDI was associated with reduced survival.ConclusionOur findings suggest that more real-world studies evaluating the association between oral chemotherapy DDIs and clinical outcomes are needed. The adverse clinical outcomes due to DDIs may be a reason for treatment failures and therapy discontinuation.
机译：由于新的药物批准以及口腔药物施用的便利性，Cheachoraral化疗使用正在增加。这种增加的使用也提高了伴随着伴随药物的药物 - 药物相互作用（DDI），导致治疗效果丧失，降低耐受性和/或毒性增加。目的是本研究的目的是审查现有的临床影响证据DDIS具有口服化学治疗剂。关于使用Pubmed的综合搜索文献，于2018年4月进行了对与口腔化疗相关的DDIS的研究。包括的研究是英文。我们包括随机临床试验，观察研究和案例报告评估任何口服化疗药物和任何其他药物之间的DDI。所包括的研究需要至少具有临床相关性的结果，这些临床相关性可能归因于DDI，例如对存活或毒性的影响。使用适合于研究设计的公布度量确定制品的质量。初始搜索中确定了2626项研究，其中35符合所有资格标准。其中包括15项回顾性队列研究，16例报告或案例系列以及四个临床试验的HOC分析。其中，DDIS有助于12项研究中临床结果的统计显着变化。这些研究中的八项评估了整体存活和无进展的存活率，发现DDI的存在与减少的存活相关。结论our调查结果表明，需要更多的实际研究评估口腔化疗DDIS和临床结果之间的关联。由于DDIS引起的不良临床结果可能是治疗失败和治疗停止的原因。

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  • 来源
    《Drugs and aging》 |2019年第4期|共14页
  • 作者

    Sharma Manvi; Vadhariya Aisha; Chikermane Soumya; Gopinathan Suma; Chavez-MacGregor Mariana; Giordano Sharon H.; Johnson Michael L.; Holmes Holly M.;

  • 作者单位

    Univ Mississippi Dept Pharm Adm Oxford MS 38677 USA;

    Univ Houston Dept Pharmaceut Hlth Outcomes &

    Policy Houston TX USA;

    Univ Houston Dept Pharmaceut Hlth Outcomes &

    Policy Houston TX USA;

    Univ Houston Dept Pharmaceut Hlth Outcomes &

    Policy Houston TX USA;

    Univ Texas MD Anderson Canc Ctr Dept Breast Med Oncol Houston TX 77030 USA;

    Univ Texas MD Anderson Canc Ctr Dept Hlth Serv Res Houston TX 77030 USA;

    Univ Houston Dept Pharmaceut Hlth Outcomes &

    Policy Houston TX USA;

    Univ Houston Dept Pharmaceut Hlth Outcomes &

    Policy Houston TX USA;

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  • 正文语种 eng
  • 中图分类 药学;
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