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Background <p>The lack of information on drug-drug interactions in the pediatric population significantly complicates making effective therapeutic decisions. Our study aimed to analyze the rate and risk factors as well as present potential drug-drug interactions (pDDIs) specifically for pediatric patients from the pediatric hemato-oncologic unit, including acute lymphoblastic leukemia (ALL) patients.</p> Methods <p>We conducted a six-month prospective study in which clinical pharmacists examined medical records once a week to look for pDDIs using the Lexicomp<sup>®</sup> Drug Interactions Checker. Spearman’s rank coefficient, logistic regression, and the U-Mann-Whitney test were used to identify correlations, analyze risk factors for pDDIs, and compare ALL patients with non-ALL patients, respectively. Recommendations were provided for the D and X pDDIs categories.</p> Results <p>We identified 507 pDDIs in 119 screened patients, 388 of which were clinically relevant. Nearly 68% of the patients were exposed to at least one significant interaction. The number of pDDIs was positively correlated with the number of medications (r<sub>s</sub>=0.75, <i>p</i> &lt; 0.001), off-label used drugs (r<sub>s</sub>=0.42, <i>p</i> &lt; 0.001), comorbidities (r<sub>s</sub>=0.21, <i>p</i> = 0.019), and hospitalization length (r<sub>s</sub>=0.48, <i>p</i> &lt; 0.001). The multivariate analysis revealed that at least 7 administered medications (OR = 8.63; 95% CI = 2.92–25.47) and 13 days in the hospital (OR = 3.47; 95% CI = 1.31–9.19) were risk factors for pDDIs. Furthermore, patients treated for ALL represent an at-risk group with a statistically higher number of drugs taken and pDDIs identified.</p> Conclusions <p>Limited data on drug-drug interactions in the pediatric population emphasizes the need for close collaboration between clinical pharmacists and clinicians to improve the safety and effectiveness of pharmacotherapy.</p>

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Potential drug-drug interactions analysis in Polish pediatric hemato-oncologic unit, including acute lymphoblastic leukemia patients

  • 期刊论文

  • 发表日期：

    2025年4月1日

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  • Arkadiusz Adamiszak,
  • Julia Drobińska,
  • Izabela Niewiadomska-Wojnałowicz,
  • Katarzyna Derwich,
  • Edmund Grześkowiak,
  • Agnieszka Bienert

摘要

Background

The lack of information on drug-drug interactions in the pediatric population significantly complicates making effective therapeutic decisions. Our study aimed to analyze the rate and risk factors as well as present potential drug-drug interactions (pDDIs) specifically for pediatric patients from the pediatric hemato-oncologic unit, including acute lymphoblastic leukemia (ALL) patients.

Methods

We conducted a six-month prospective study in which clinical pharmacists examined medical records once a week to look for pDDIs using the Lexicomp® Drug Interactions Checker. Spearman’s rank coefficient, logistic regression, and the U-Mann-Whitney test were used to identify correlations, analyze risk factors for pDDIs, and compare ALL patients with non-ALL patients, respectively. Recommendations were provided for the D and X pDDIs categories.

Results

We identified 507 pDDIs in 119 screened patients, 388 of which were clinically relevant. Nearly 68% of the patients were exposed to at least one significant interaction. The number of pDDIs was positively correlated with the number of medications (rs=0.75, p < 0.001), off-label used drugs (rs=0.42, p < 0.001), comorbidities (rs=0.21, p = 0.019), and hospitalization length (rs=0.48, p < 0.001). The multivariate analysis revealed that at least 7 administered medications (OR = 8.63; 95% CI = 2.92–25.47) and 13 days in the hospital (OR = 3.47; 95% CI = 1.31–9.19) were risk factors for pDDIs. Furthermore, patients treated for ALL represent an at-risk group with a statistically higher number of drugs taken and pDDIs identified.

Conclusions

Limited data on drug-drug interactions in the pediatric population emphasizes the need for close collaboration between clinical pharmacists and clinicians to improve the safety and effectiveness of pharmacotherapy.