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Sensitivity and specificity of drug interaction databases to detect interactions with recently approved oral

John B Bossaer1, Danielle Eskens2, Austin Gardner3

  • 1Gatton College of Pharmacy, Johnson City, TN, USA.

Journal of Oncology Pharmacy Practice : Official Publication of the International Society of Oncology Pharmacy Practitioners
|January 13, 2021
PubMed
Abstract

Insights

Drug-drug interaction databases show significant variability in detecting oral antineoplastic interactions. Clinicians must remain vigilant when screening for these potentially harmful drug-drug interactions.

Area of Science:

  • Oncology
  • Pharmacology
  • Clinical Pharmacy

Background:

  • Drug-drug interactions (DDIs) with oral antineoplastics (OAs) are a growing concern due to increased OA approvals and usage.
  • A prior pilot study indicated significant variability in DDI screening databases' sensitivity for detecting clinically relevant DDIs with OAs.

Purpose of the Study:

  • To expand upon previous work by analyzing a larger number of potential DDIs with OAs.
  • To assess the sensitivity and specificity of commonly used DDI screening databases for oral antineoplastics.

Main Methods:

  • Included 22 newly approved OAs (2016-2019) and reviewed their prescribing information.
  • Created a list of 229 explicit and theoretical DDIs, adjudicated for clinical significance by an oncology pharmacist.
  • Analyzed the sensitivity and specificity of five DDI databases (Lexicomp®, Micromedex®, Medscape, Epocrates®, & Drugs.com) using 64 false DDI pairs for specificity analysis.

Main Results:

  • Significant variability was observed among databases in sensitivity, specificity, and accuracy (p < 0.0001).
  • Lexicomp® (355), Drugs.com (352), and Epocrates® (344) demonstrated higher accuracy scores compared to Micromedex® (270) and Medscape (280).

Conclusions:

  • Substantial variability exists among DDI screening databases concerning oral antineoplastics.
  • Clinicians should exercise vigilance when screening for and documenting DDIs involving OAs.
Keywords:
Drug interactiondatabaseoral antineoplasticspharmacovigilance

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