潜在药物-药物-基因相互作用的流行:使用瑞士索赔数据的描述性研究
Nina L Wittwer1,2, Christoph R Meier1,2,3, Carola A Huber4
1Basel Pharmacoepidemiology Unit, Division of Clinical Pharmacy and Epidemiology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland.
瑞士人口中很大一部分人经历了药物相互作用,包括药物基因组 (PGx) 药物和酶抑制剂/诱导剂. 这些相互作用,特别是与CYP2D6和CYP2C19,凸显了在PGx测试中需要考虑非遗传因素的必要性.
科学领域:
- 药物基因组学
- 药物新陈代谢
- 临床药房
背景情况:
- 药物基因组 (PGx) 测试指导药物选择和剂量.
- 细胞P450酶 (CYP2C9,CYP2C19,CYP2D6) 在药物代谢中起着至关重要的作用.
- 涉及PGx药物和酶修饰剂的药物相互作用 (DDI) 可以改变治疗结果.
研究的目的:
- 在瑞士人群中确定PGx药物及其代谢酶抑制剂/诱导剂之间的相互作用的发生率.
- 评估与CYP2C9,CYP2C19和CYP2D6抑制剂或诱导剂同时使用PGx药物的频率.
主要方法:
- 在2017年至2021年间使用了瑞士保险公司 (Helsana) 的索赔数据.
- 根据时间窗口 (±5或±30天) 定义的PGx药物和酶修饰剂的同时使用.
- 分析了894748名连续保险人的数据.
主要成果:
- 17. 4% 到 24. 8% 的个体暴露在可能相互作用的药物对中.
- 其中1.5%至2.2%受到了潜在的强相互作用药物对.
- 与CYP2D6和CYP2C19的相互作用是最常见的;受影响的个体更有可能是女性,老年人,并服用更多药物.
结论:
- 涉及PGx药物的DDI高患病率需要考虑非遗传因素.
- 药物诱导的转换会显著影响PGx测试的解释.
- 临床实践应考虑这些相互作用以优化药物治疗.
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