ABSTRACT

Objectives:

Our aim was to determine risk factors for and frequency of potential drug-drug interactions (pDDIs) among hospitalized patients with myasthenia gravis (MG).

Methods:

This was a retrospective cross-sectional study of the-first time hospitalized MG patients or patients hospitalized because of the exacerbation of MG at the Neurology Clinic of the Clinical Center of Serbia, Belgrade. Medical records and discharge summaries of hospitalized MG patients over a 10-year period were reviewed. The pDDIs were identified by means of Micromedex, and multivariate regression methods were used to reveal potential predictors of number of pDDIs per patient.

Results:

The study included 687 patients with MG. In total, 2041 pDDIs were detected in 608 (88.5%) patients. Among the discovered pDDIs, 329 different pDDIs were observed. The most frequent pDDIs were pyridostigmine-prednisone (487patients/70.9%) and aspirin-prednisone (90 patients/13.1%) classified as moderate, and enalapril-potassium chloride (71patients/10.3%) classified as major pDDI. Five drugs (aspirin, insulin, prednisone, cyclosporine, metformin) were responsible for 22.6% of different pDDIs. Dyspnea, generalized form of MG, diabetes mellitus, hypertension, total number of drugs-used, use of antiplatelets were identified as the relevant risk factors for total number of pDDIs (R2 = 0.626,F = 73.797, p < 0.001), while age of patients and history of cancer were inversely correlated with such an outcome.

Conclusion:

The frequency of the pDDIs in hospitalized MG patients is high, and adversely influenced by dyspnea, generalized MG, diabetes mellitus, hypertension, total number of drugs-used and use of antiplatelets.

中文翻译：

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重症肌无力患者潜在药物相互作用的危险因素

摘要

目标：

我们的目的是确定重症肌无力 (MG) 住院患者中潜在药物相互作用 (pDDI) 的风险因素和频率。

方法：

这是一项在贝尔格莱德塞尔维亚临床中心神经病学诊所对首次住院 MG 患者或因 MG 恶化住院的患者进行的回顾性横断面研究。审查了 10 年期间住院 MG 患者的医疗记录和出院总结。pDDI 是通过 Micromedex 确定的，并使用多变量回归方法来揭示每位患者 pDDI 数量的潜在预测因素。

结果：

该研究包括 687 名 MG 患者。总共在 608 名 (88.5%) 患者中检测到 2041 种 pDDI。在发现的 pDDI 中，观察到了 329 种不同的 pDDI。最常见的 pDDI 是吡啶斯的明-泼尼松 (487 名患者/70.9%) 和阿司匹林-泼尼松 (90 名患者/13.1%) 被归类为中度，依那普利-氯化钾 (71 名患者/10.3%) 被归类为主要 pDDI。五种药物（阿司匹林、胰岛素、泼尼松、环孢素、二甲双胍）占不同 pDDI 的 22.6%。呼吸困难、全身型 MG、糖尿病、高血压、药物使用总数、抗血小板使用被确定为 pDDI 总数的相关危险因素（R2 = 0.626，F = 73.797，p < 0.001），而年龄患者的数量和癌症病史与这种结果呈负相关。

结论：

住院 MG 患者的 pDDIs 频率很高，并且受到呼吸困难、全身性 MG、糖尿病、高血压、药物使用总数和抗血小板使用的不利影响。