Drug interactions in the treatment of rheumatoid arthritis and psoriatic arthritis

Pflugbeil, Stephan; Böckl, Karin; Pongratz, Reinhold; Leitner, Marianne; Graninger, Winfried; Ortner, Astrid

doi:10.1007/s00296-020-04526-3

Cited by 16 publications

(13 citation statements)

References 63 publications

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“…The number of patients affected by polypharmacy considerably varies when using different definitions (3). Polypharmacy may result in unwanted drug interactions (4), and/or lead to an increase of adverse and serious adverse events, with more frequent admissions to hospitals, thus extending the costs of health care (5). In elderly people over 65 years, more than 50% are prescribed more than 6 medications, and almost 20% receive an inappropriate drug (5).…”

Section: Introductionmentioning

confidence: 99%

Polypharmacy in Middle-European Rheumatoid Arthritis-Patients: A Retrospective Longitudinal Cohort Analysis With Systematic Literature Review

et al. 2020

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Objective: To assess polypharmacy and related medication aspects in Middle-European rheumatoid arthritis (RA) patients, and to discuss the results in view of a systematic literature review.Methods: In this retrospective cohort study, charts were reviewed from RA-patients consecutively recruited between September 27, 2017 and April 29, 2019. Drugs were assigned to the Anatomical Therapeutic Chemical (ATC) groups as proposed by the World Health Organization (WHO). Results were compared to those of a systematic literature review.Results: One hundred seventy-five consecutive RA-patients were included. The mean number of drugs was 6.6 ± 3.5, with 2.4 ± 1.2 drugs taken specifically for RA—compared to 2.6 in the literature. 33.7% of patients experienced polypharmacy defined by ≥5 drugs, compared to 61.6% in the literature–with women affected more frequently than men. After 7 years of follow-up, the number of drugs increased in all ATC-groups by an average of 12.7 %, correlating with age (Corrcoeff = 0.46) and comorbidities (Corrcoeff = 0.599). In the literature, polypharmacy is not always defined precisely, and has not been considered in management guidelines so far.Conclusion: Polypharmacy is a frequent issue in RA-management. With an increasing number of comorbidities during the course of the disease, polypharmacy becomes even more relevant.

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Section: Introductionmentioning

confidence: 99%

Polypharmacy in Middle-European Rheumatoid Arthritis-Patients: A Retrospective Longitudinal Cohort Analysis With Systematic Literature Review

et al. 2020

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“…Polypharmacy can lead to adverse drug interactions ( 83 ) and increase severe adverse events, thereby increasing healthcare costs ( 84 ). In elderly patients over 65 years of age, 50% will be prescribed more than 6 drugs, and nearly 20% will receive inappropriate medication ( 84 ).…”

Section: Resultsmentioning

confidence: 99%

Identification of Five Quality Needs for Rheumatology (Text Analysis and Literature Review)

Pallua

Schirmer

2021

Front. Med.

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Background: While the use of the term “quality” in industry relates to the basic idea of making processes measurable and standardizing processes, medicine focuses on achieving health goals that go far beyond the mere implementation of diagnostic and therapeutic processes. However, the quality management systems used are often simple, self-created concepts that concentrate on administrative processes without considering the quality of the results, which is essential for the patient. For several rheumatic diseases, both outcome and treatment goals have been defined. This work summarizes current mainstreams of strategies with published quality efforts in rheumatology.Methods: PubMed, Cochrane Library, and Web of Science were used to search for studies, and additional manual searches were carried out. Screening and content evaluation were carried out using the PRISMA-P 2015 checklist. After duplicate search in the Endnote reference management software (version X9.1), the software Rayyan QCRI (https://rayyan.qcri.org) was applied to check for pre-defined inclusion and exclusion criteria. Abstracts and full texts were screened and rated using Voyant Tools (https://voyant-tools.org/). Key issues were identified using the collocate analysis.Results: The number of selected publications was small but specific (14 relevant correlations with coefficients >0.8). Using trend analysis, 15 publications with relative frequency of keywords >0.0125 were used for content analysis, revealing 5 quality needs. The treat to target (T2T) initiative was identified as fundamental paradigm. Outcome parameters required for T2T also allow quality assessments in routine clinical work. Quality care by multidisciplinary teams also focusing on polypharmacy and other quality aspects become essential, A global software platform to assess quality aspects is missing. Such an approach requires reporting of multiple outcome parameters according to evidence-based clinical guidelines and recommendations for the different rheumatic diseases. All health aspects defined by the WHO (physical, mental, and social health) have to be integrated into the management of rheumatic patients.Conclusion: For the future, quality projects need goals defined by T2T based initiatives in routine clinical work, secondary quality goals include multidisciplinary cooperation and reduction of polypharmacy. Quality indicators and standards in different health systems will provide new information to optimize patients' care in different health systems.

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“…A change in pharmacokinetics and pharmacodynamics occurs during sepsis [29] and studies have shown a relatively high frequency of pDDIs in patients with sepsis treated in ICU [30]. Also, the patients with autoimmune disease were significantly exposed to pDDIs [31].…”

Section: Discussionmentioning

confidence: 99%

Focus group and Delphi process: Stroke and potential drug-drug Interactions (pDDI) in the neurological Intensive Care Unit (NICU)

Aleksić¹,

Petković²,

Milosavljević³

et al. 2021

Hosp Pharm Int Multi J

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Introduction: The clinical significance of potential drug-drug interactions (pDDIs), especially in the intensive care unit (ICU) manifested mostly as adverse drug reactions. Aim: The goal of this research was to conduct a focus group, in which the participants were decisionmakers in acute ischemic stroke patient treatment. Also, the aim was to reach a consensus, due to the Delphi process, between neurologists and clinical pharmacologists regarding this highly vulnerable group of patients. Material and Methods: In this academic research, so-called applied focus group (the goal was to reach practical decisions) and clinical focus group (determining motives, predeterminations, bias, prejudice and analyzing the behavior leading to a certain outcome) was done. Results: Continuing medical education of neurologists is needed regarding pDDIs and the use of an online pDDIs checker. Certain groups of patients with AIS are at particular risk of exposure to pDDIs. Certain drug groups are more likely to interact with other drugs. Conclusions: Defining medical recommendations/guidelines on evidence base medicine about pDDIs in patients with AIS would significantly contribute to reducing their frequency in this vulnerable patient population.

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Drug interactions in the treatment of rheumatoid arthritis and psoriatic arthritis

Cited by 16 publications

References 63 publications

Polypharmacy in Middle-European Rheumatoid Arthritis-Patients: A Retrospective Longitudinal Cohort Analysis With Systematic Literature Review

Polypharmacy in Middle-European Rheumatoid Arthritis-Patients: A Retrospective Longitudinal Cohort Analysis With Systematic Literature Review

Identification of Five Quality Needs for Rheumatology (Text Analysis and Literature Review)

Focus group and Delphi process: Stroke and potential drug-drug Interactions (pDDI) in the neurological Intensive Care Unit (NICU)

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