PMID- 31364373
OWN - NLM
STAT- MEDLINE
DCOM- 20200703
LR  - 20200703
IS  - 1542-6270 (Electronic)
IS  - 1060-0280 (Linking)
VI  - 54
IP  - 1
DP  - 2020 Jan
TI  - The Incidence and Severity of Drug Interactions Before and After Antiretroviral 
      Therapy Simplification in Treatment-Experienced Patients With HIV Infection.
PG  - 36-42
LID - 10.1177/1060028019867970 [doi]
AB  - Background: Current guidelines advocate for antiretroviral therapy (ART) 
      simplification in patients on complicated regimens. Simplifying ART improves 
      patient adherence and quality of life, but changes in drug interactions (DIs) are 
      uncertain. Objective: This study assessed changes in DIs following ART 
      simplification in patients with HIV. Methods: This was an observational, 
      retrospective cohort study of patients attending an urban HIV clinic. Patients 
      were included if they had ART simplification (a decreased number of daily 
      tablets) and >/=1 concomitant medication (CM). Total DI scores were generated for 
      each patient pre-ART simplification and post-ART simplification using an online 
      DI database. Each ART-CM pair labeled as "do not co-administer" was given a score 
      of 2, "potential interaction" a score of 1, or "no interaction" a score of 0. 
      Differences in total DI scores following simplification were analyzed with a 
      Wilcoxon Signed-Rank test. Predictors of DI score reductions were examined with 
      linear regression. Results: A total of 99 patients were included. Their median 
      age was 54 years, and 79% were male. The median durations of HIV infection and 
      ART were 16 and 10 years, respectively. Patients were receiving an average of 4.5 
      CMs. Median interaction scores presimplification and postsimplification were 3 
      (interquartile range [IQR], 1-6) and 1 (IQR, 0-2) respectively (P < 0.001). 
      Predictors of score reductions were the patient's number of CMs, discontinuing a 
      protease inhibitor, and switching to a dolutegravir-based regimen. Conclusion and 
      Relevance: ART simplification decreased the incidence of DIs in this analysis of 
      patients with advanced age who had ART experience and polypharmacy.
FAU - Hastain, Nicholas V
AU  - Hastain NV
AD  - Jefferson College of Pharmacy, Thomas Jefferson University, Philadelphia, PA, 
      USA.
FAU - Santana, Aleena
AU  - Santana A
AD  - Jefferson College of Pharmacy, Thomas Jefferson University, Philadelphia, PA, 
      USA.
FAU - Schafer, Jason J
AU  - Schafer JJ
AUID- ORCID: 0000-0003-1231-0973
AD  - Jefferson College of Pharmacy, Thomas Jefferson University, Philadelphia, PA, 
      USA.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20190731
PL  - United States
TA  - Ann Pharmacother
JT  - The Annals of pharmacotherapy
JID - 9203131
RN  - 0 (Anti-Retroviral Agents)
RN  - 0 (Drug Combinations)
RN  - 0 (Tablets)
SB  - IM
MH  - Adult
MH  - *Anti-Retroviral Agents/administration & dosage/adverse 
      effects/pharmacokinetics/therapeutic use
MH  - Drug Administration Schedule
MH  - Drug Combinations
MH  - Drug Interactions
MH  - Female
MH  - HIV Infections/*drug therapy/metabolism
MH  - Humans
MH  - Incidence
MH  - Male
MH  - Medication Adherence
MH  - Middle Aged
MH  - Quality of Life
MH  - Retrospective Studies
MH  - Tablets
OTO - NOTNLM
OT  - HIV/AIDS
OT  - antiretrovirals
OT  - drug interactions
OT  - drug safety
OT  - infectious diseases
EDAT- 2019/08/01 06:00
MHDA- 2020/07/04 06:00
CRDT- 2019/08/01 06:00
PHST- 2019/08/01 06:00 [pubmed]
PHST- 2020/07/04 06:00 [medline]
PHST- 2019/08/01 06:00 [entrez]
AID - 10.1177/1060028019867970 [doi]
PST - ppublish
SO  - Ann Pharmacother. 2020 Jan;54(1):36-42. doi: 10.1177/1060028019867970. Epub 2019 
      Jul 31.