Model-Based Comparative Analysis of Rifampicin and Rifabutin Drug-Drug Interaction Profile

Tuloup, Vianney; Garreau, Romain; Bleyzac, Nathalie; Bourguignon, Laurent; Tod, Michel; Goutelle, Sylvain

doi:10.1128/aac.01043-21

Cited by 17 publications

(9 citation statements)

References 88 publications

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“…Despite being a core recommendation, the benefit of adjunctive rifampicin therapy in staphylococcal prosthetic valve IE is uncertain [ 115 , 116 ]. It implies a high risk of clinically relevant drug interactions [ 117 , 118 ], which constitutes a differential problem in older polymedicated patients. In non-HACEK GNB etiology, combination therapy with quinolones may be associated with a better prognosis, but additional studies are needed to define the optimal treatment for these patients [ 51 ].…”

Section: Antibiotic Treatment: the Shorter The Better Diminishing Int...mentioning

confidence: 99%

Infective Endocarditis in the Elderly: Challenges and Strategies

Bea

Vela

García‐Blas

et al. 2022

JCDD

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The specific management of infective endocarditis (IE) in elderly patients is not specifically addressed in recent guidelines despite its increasing incidence and high mortality in this population. The term “elderly” corresponds to different ages in the literature, but it is defined by considerable comorbidity and heterogeneity. Cancer incidence, specifically colorectal cancer, is increased in older patients with IE and impacts its outcome. Diagnosis of IE in elderly patients is challenging due to the atypical presentation of the disease and the lower performance of imaging studies. Enterococcal etiology is more frequent than in younger patients. Antibiotic treatment should prioritize diminishing adverse effects and drug interactions while maintaining the best efficacy, as surgical treatment is less commonly performed in this population due to the high surgical risk. The global assessment of elderly patients with IE, with particular attention to frailty and geriatric profiles, should be performed by multidisciplinary teams to improve disease management in this population.

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Section: Antibiotic Treatment: the Shorter The Better Diminishing Int...mentioning

confidence: 99%

Infective Endocarditis in the Elderly: Challenges and Strategies

Bea

Vela

García‐Blas

et al. 2022

JCDD

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“…Rifampin is a more potent inducer for the cytochrome (CYP) enzyme system (i.e., strong inducer for CYP3A4 and CYP2C19; moderate inducer for CYP2B6, CYP2C8, and CYP2C9; weak inducer for CYP1A2) while rifabutin only induces CYP3A4 and to a lesser extent ( Shulha et al, 2019 ). Tuloup and colleagues indicated that rifabutin, contrary to rifampin, does not appear likely to cause severe drug-drug interactions, even with sensitive CYP substrates ( Tuloup et al, 2021 ).…”

Section: Discussionmentioning

confidence: 99%

Comparison of Rifabutin-Based Versus Rifampin-Based Regimens for the Treatment of Mycobacterium avium Complex: A meta-Analysis Study

et al. 2021

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Background: The incidence of Mycobacterium avium complex (MAC) increases as immunosuppressed conditions become more common. MAC's standard treatment regimen includes a macrolide, ethambutol, and a rifamycin, among which rifampin and rifabutin are the most commonly used. Although current guidelines recommend initial therapy for MAC with rifampin, it has been theorized to be less efficacious than rifabutin.Methods: We reviewed the relevant scientific literature published up to February 18, 2020. Statistical analyses were performed with Comprehensive Meta-Analysis Software Version 2.0 (Biostat, Englewood, NJ). The pooled frequency with 95% confidence intervals (CI) was assessed using a random-effect model. We considered P <0.05 as statistically significant for publication bias.Results: After reviewing 3665 records, we identified 24 studies that satisfied the inclusion criteria. Among these studies, 8 had rifabutin in their regimens (rifabutin group) and 16 had rifampin in their regimens (rifampin group). The estimated pooled treatment success rate was found to be 54.7% (95% CI 41.0-67.0%) in rifabutin groups and 67.5% (95% CI 55.7-77.4%) in rifampin groups. There was no evidence of publication bias among the included studies (Egger’s test p-value was 0.7).Conclusion: In this study, it was shown that in comparison to Rifabutin, rifampin has similar treatment success rates in treating MAC. In order to determine the exact preference of each of these drugs, double-blind clinical trial studies are recommended.

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“…Metabolized by esterases and CYP3A4 Autoinduction of metabolism 0.81 12 Minimal 12 0.98 13 Rifapentine Metabolized by esterases Human data not available Human data not available Human data not available Note: Free n shading = no to weak induction effect (AUC ratio 1.0-0.51); yellow shading = moderate induction effect (AUC ratio 0.5-0.2); red shading = strong induction effect (AUC ratio <0.2).…”

Section: Rifabutinmentioning

confidence: 99%

“…Strong enzyme inducers are those that reduce the area under the curve (AUC) of coadministered substrates by more than 80%, while moderate inducers reduce AUC by 50–80% and weak inducers by 20%–49% 10 . Of the rifamycins, rifampin is generally considered the most potent enzyme inducer and rifabutin the least, while rifapentine potency depends on its frequency of administration; however, effects may vary by the specific enzymes involved as well as the dose and dosing schedule 11–14 1 provides example data for comparative changes in AUC values based on several human pharmacokinetic studies, though direct quantitative cross‐comparisons are limited by differing study conditions.…”

Section: Introductionmentioning

confidence: 99%

Systematic review of drug–drug interactions between rifamycins and anticoagulant and antiplatelet agents and considerations for management

et al. 2022

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Rifamycins (rifampin, rifabutin, and rifapentine) play an essential role in the treatment of mycobacterial and some nonmycobacterial infections. They also induce the activity of various drug transporting and metabolizing enzymes, which can impact the concentrations and efficacy of substrates. Many anticoagulant and antiplatelet (AC/AP) agents are substrates of these enzymes and have narrow therapeutic indices, leading to risks of thrombosis or bleeding when coadministered with rifamycins. The objective of this systematic review was to evaluate the effects on AC/AP pharmacokinetics, laboratory markers, and clinical safety and efficacy of combined use with rifamycins. A systematic review following the Preferred Reporting Items for Systematic Reviews and Meta‐analyses guidance was performed. The PubMed, Embase, and Web of Science databases were queried for English‐language reports on combination use of rifamycins and AC/AP agents from database inception through August 2021. The 29 studies identified examined warfarin (n = 17), direct oral anticoagulants (DOACs) (n = 8), and antiplatelet agents (n = 4) combined with rifampin (n = 28) or rifabutin (n = 1). Eleven studies were case reports or small case series; 14 reported on pharmacokinetic or laboratory markers in healthy volunteers. Rifampin‐warfarin combinations led to reductions in warfarin area under the curve (AUC) of 15%–74%, with variability by warfarin isomer and study. Warfarin dose increases of up to 3–5 times prerifampin doses were required to maintain coagulation parameters in the therapeutic range. DOAC AUCs were decreased by 20%–67%, with variability by individual agent and with rifampin versus rifabutin. The active metabolite of clopidogrel increased substantially with rifampin coadministration, whereas prasugrel was largely unaffected and ticagrelor saw decreases. Our review suggests most combinations of AC/AP agents and rifampin are problematic. Further studies are required to determine whether rifabutin or rifapentine could be safe alternatives for coadministration with AC/AP drugs.

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Model-Based Comparative Analysis of Rifampicin and Rifabutin Drug-Drug Interaction Profile

Cited by 17 publications

References 88 publications

Infective Endocarditis in the Elderly: Challenges and Strategies

Infective Endocarditis in the Elderly: Challenges and Strategies

Comparison of Rifabutin-Based Versus Rifampin-Based Regimens for the Treatment of Mycobacterium avium Complex: A meta-Analysis Study

Systematic review of drug–drug interactions between rifamycins and anticoagulant and antiplatelet agents and considerations for management

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