urc mondor

Unité de Recherche Clinique Henri Mondor

Potential drug-drug interactions and risk of unplanned hospitalization in older patients with cancer: A survey of the prospective ELCAPA (ELderly CAncer PAtients) cohort.

Beinse G, Reitter D, Segaux L, Carvahlo-Verlinde M, Rousseau B, Tournigand C, Cudennec T, Laurent M, Boudou-Rouquette P, Paillaud E, Canoui-Poitrine F, Caillet P J Geriatr Oncol. 2020;11(4):586-592.

<p><b>BACKGROUND: </b>Because of comorbidities and polypharmacy, older patients with cancer have a greater risk of iatrogenic events. We aimed to characterize potential drug-drug interactions (PDIs) and the risk of unplanned hospitalization in older patients with cancer treated with antineoplastic agents (ANAs).</p><p><b>METHODS: </b>We analyzed all older patients (≥70 years) from the prospective ELCAPA cohort referred for geriatric assessment (2007-2014) prior to treatment with ANA at Henri Mondor Hospital (Créteil, France). PDIs were identified using Lexicomp®, and Theriaque® for French medications. Factors associated with PDIs, and association between PDIs and unplanned hospitalization in the 6 months following geriatric assessment were analyzed using ordered multivariate logistic regression (MLR).</p><p><b>RESULTS: </b>We included 442 patients (median [interquartile range] age: 77 years [74-80]); number of medications/patient/day: 6 [3-8]); ECOG-PS ≤ 2: 79%; metastasis: 70%). Most patients had a digestive tract cancer (colorectal: 22%; upper digestive tract: 23%). We identified 1742 PDIs; 76.5% of patients had ≥1 PDI; 13% of the PDIs involved an ANA. In a multivariate analysis, cardiovascular disorders (ischemic heart disease, heart failure, atrial fibrillation and/or arterial hypertension) were independently associated with PDIs (p < .001, after adjustment for polypharmacy and tumor site/stage). A high number of PDIs between two daily medications was independently associated with the risk of unplanned hospitalization (adjusted-odds ratio [95% confidence interval] per PDI: 1.05 [1.00;1.11], p = .05), while polypharmacy was not.</p><p><b>CONCLUSION: </b>Patients with cardiovascular comorbidities were more likely to have a PDI. A higher number of PDIs may be an independent risk factor for early unplanned hospitalization.</p>

MeSH terms: Aged; Drug Interactions; France; Hospitalization; Humans; Neoplasms; Pharmaceutical Preparations; Prospective Studies
DOI: 10.1016/j.jgo.2019.07.023