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Wilson GJ, Kark AL, Francis LP, Hoy W, Healy HG, Mallett AJ. The increasing rates of acute interstitial nephritis in Australia: a single centre case series. BMC Nephrol 2017; 18:329. [PMID: 29089041 PMCID: PMC5664794 DOI: 10.1186/s12882-017-0747-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 10/23/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The Australian Institute of Health and Welfare's first report into acute kidney injury demonstrated a significant increase in the incidence of acute-tubulo interstitial nephritis, the ICD-10 code representing both acute interstitial nephritis and pyelonephritis, in women aged less than 55 years. In contrast, recent case series have reported rising rates of drug induced acute interstitial nephritis predominantly among elderly patients. Due to several limitations with the Australian Institute of Health and Welfare report, this new trend requires further investigation to determine if rates of acute interstitial nephritis are truly increasing among younger Australian women. METHODS Patients who underwent a renal biopsy at a single center from 2000 to 2015 were reviewed and those with biopsy confirmed acute interstitial nephritis were selected. Cause of acute interstitial nephritis, patient demographics, co-morbidities and renal indices for these patients when available were recorded and compared. RESULTS Eight hundred ninety-eight patients who underwent renal biopsy from 2000 to 2015 were reviewed and 40 patients were identified with biopsy confirmed acute interstitial nephritis. The rate of acute interstitial nephritis increased significantly over the study period (4 patients/2.2% of biopsies performed in 2000-03 vs. 19 patients/6.7% of all biopsies performed in 2012-15; p = 0.002). There was a marked increase in the number of women with AIN in the last four years of the study (2 patients and 2.1% of biopsies performed in women in 2000-2003 compared with 13 patients and 9.0% of biopsies performed in women in 2012-2015). Immune mediated causes of acute interstitial nephritis and NSAID associated AIN were more common in women (9 females vs. 3 males), occurred more frequently in the last eight years of the study and predominantly in patients under 55 years of age. CONCLUSIONS Our study demonstrates a significant increase in the number of patients with biopsy confirmed AIN. Also, we provide preliminary evidence in support of an increase in rates of younger women with immune mediated acute interstitial nephritis. These results support the findings of the Australian Institute of Health and Welfare and suggest that younger women may be at higher risk of immune mediated and NSAID associated acute interstitial nephritis.
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Affiliation(s)
- Gregory J Wilson
- Department of Renal Medicine, Royal Brisbane and Women's Hospital, Herston, QLD, 4029, Australia. .,CKD.QLD & NHMRC CKD.CRE, The University of Queensland, Herston, QLD, Australia. .,School of Medicine, The University of Queensland, Herston, QLD, Australia.
| | - Adrian L Kark
- Department of Renal Medicine, Royal Brisbane and Women's Hospital, Herston, QLD, 4029, Australia.,CKD.QLD & NHMRC CKD.CRE, The University of Queensland, Herston, QLD, Australia
| | - Leo P Francis
- Department of Pathology, Royal Brisbane and Women's Hospital, Herston, QLD, Australia
| | - Wendy Hoy
- CKD.QLD & NHMRC CKD.CRE, The University of Queensland, Herston, QLD, Australia.,Centre for Chronic Disease, The University of Queensland, Herston, QLD, Australia
| | - Helen G Healy
- Department of Renal Medicine, Royal Brisbane and Women's Hospital, Herston, QLD, 4029, Australia.,CKD.QLD & NHMRC CKD.CRE, The University of Queensland, Herston, QLD, Australia.,Centre for Chronic Disease, The University of Queensland, Herston, QLD, Australia
| | - Andrew J Mallett
- Department of Renal Medicine, Royal Brisbane and Women's Hospital, Herston, QLD, 4029, Australia.,CKD.QLD & NHMRC CKD.CRE, The University of Queensland, Herston, QLD, Australia.,School of Medicine, The University of Queensland, Herston, QLD, Australia
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Barozzi N, Peeters GMEEG, Tett SE. Actions following adverse drug events - how do these influence uptake and utilisation of newer and/or similar medications? BMC Health Serv Res 2015; 15:498. [PMID: 26545734 PMCID: PMC4635584 DOI: 10.1186/s12913-015-1165-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2015] [Accepted: 11/03/2015] [Indexed: 11/10/2022] Open
Abstract
Background Over the last decade, actions following some adverse drug events received major publicity. This study investigated changes in usage patterns of medications in Australia following two examples - rofecoxib market withdrawal (2004) and warnings about jaw necrosis following bisphosphonates (2007). Methods Dispensing data for COX-2 inhibitors (2000–2008) and anti-osteoporosis medications (2003–2012) were obtained from the Australian Pharmaceutical Benefits Scheme database. For bisphosphonates, data on Australian marketing expenditures were purchased from CegedimR. Results For COX-2 inhibitors, celecoxib dispensing halved after rofecoxib withdrawal, but meloxicam dispensing increased by 60 %. When lumiracoxib was introduced (2006) there was uptake of prescribing at a faster rate than meloxicam in 2002, its first year of use. For bisphosphonates, alendronate had highest use at the time of the warnings (8.3 DDD/1000/day), dropping to 4.9 DDD/1000/day by 2012. In contrast, risedronate use rose 2007–2012 from 4.1 to 4.9 DDD/1000/day. There was 49 % increase in reported annual expenditure on detailing for risedronate from 2007 to 2008 (to AUD$7.3 million) and only 29 % increase for alendronate (to AUD$3.1 million). Conclusions The rapid uptake of prescribing of lumiracoxib and increased use of meloxicam flagged a concern, especially after rofecoxib withdrawal due to safety issues. Bisphosphonates are useful drugs, however the dramatic rise in expenditure on detailing, followed by a rise in utilisation of risedronate could suggest that adverse publicity triggered a marketing response. These examples highlight the importance of tracking utilisation of medication classes in real time, using different data as needed, to ensure that due caution is exercised (and quick intervention provided if needed) for medications in the same class. Electronic supplementary material The online version of this article (doi:10.1186/s12913-015-1165-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Nadia Barozzi
- School of Pharmacy, The University of Queensland, Brisbane, QLD, 4072, Australia. .,Healthy 4Life, PO Box 41, 4009, Basel, Switzerland.
| | - G M E E Geeske Peeters
- Schools of Population Health and Human Movement Studies, The University of Queensland, Brisbane, QLD, 4072, Australia.
| | - Susan E Tett
- School of Pharmacy, The University of Queensland, Brisbane, QLD, 4072, Australia.
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Recomendaciones para una prescripción segura de antiinflamatorios no esteroideos: documento de consenso elaborado por expertos nominados por 3 sociedades científicas (SER-SEC-AEG). GASTROENTEROLOGIA Y HEPATOLOGIA 2014; 37:107-27. [DOI: 10.1016/j.gastrohep.2013.11.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Accepted: 11/12/2013] [Indexed: 12/17/2022]
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Lanas A, Benito P, Alonso J, Hernández-Cruz B, Barón-Esquivias G, Perez-Aísa Á, Calvet X, García-Llorente JF, Gobbo M, Gonzalez-Juanatey JR. Safe prescription recommendations for non steroidal anti-inflammatory drugs: consensus document ellaborated by nominated experts of three scientific associations (SER-SEC-AEG). ACTA ACUST UNITED AC 2014; 10:68-84. [PMID: 24462644 DOI: 10.1016/j.reuma.2013.10.004] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Revised: 10/22/2013] [Accepted: 10/23/2013] [Indexed: 02/06/2023]
Abstract
This article outlines key recommendations for the appropriate prescription of non steroidal anti-inflammatory drugs to patients with different musculoskeletal problems. These recommendations are based on current scientific evidence, and takes into consideration gastrointestinal and cardiovascular safety issues. The recommendations have been agreed on by experts from three scientific societies (Spanish Society of Rheumatology [SER], Spanish Association of Gastroenterology [AEG] and Spanish Society of Cardiology [SEC]), following a two-round Delphi methodology. Areas that have been taken into account encompass: efficiency, cardiovascular risk, gastrointestinal risk, liver risk, renal risk, inflammatory bowel disease, anemia, post-operative pain, and prevention strategies. We propose a patient management algorithm that summarizes the main aspects of the recommendations.
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Affiliation(s)
- Angel Lanas
- Servicio de Aparato Digestivo, Hospital Clínico Lozano Blesa, Universidad de Zaragoza, IIS Aragón, CIBERehd, Zaragoza, España.
| | - Pere Benito
- Servicio de Reumatología, Hospital del Mar, Universidad Autónoma de Barcelona, Barcelona, España
| | - Joaquín Alonso
- Servicio de Cardiología, Hospital Universitario de Fuenlabrada, Fuenlabrada, Madrid, España
| | - Blanca Hernández-Cruz
- i+D+I, Unidad de Gestión Clínica de Reumatología, Servicio de Reumatología, Hospital Universitario Virgen Macarena, Sevilla, España
| | - Gonzalo Barón-Esquivias
- Servicio de Cardiología, Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Sevilla, España
| | - Ángeles Perez-Aísa
- Unidad de Digestivo, Agencia Sanitaria Costa del Sol, Marbella, Málaga, España
| | - Xavier Calvet
- Servei de Digestiu, Hospital de Sabadell, Universidad Autónoma de Barcelona, CIBERehd, Sabadell, Barcelona, España
| | | | - Milena Gobbo
- Unidad de Investigación, Sociedad Española de Reumatología, Madrid, España
| | - José R Gonzalez-Juanatey
- Servicio de Cardiología y Unidad Coronaria, Hospital Clínico Universitario, Santiago de Compostela, La Coruña, España
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Adams RJ, Appleton SL, Gill TK, Taylor AW, Wilson DH, Hill CL. Cause for concern in the use of non-steroidal anti-inflammatory medications in the community--a population-based study. BMC FAMILY PRACTICE 2011; 12:70. [PMID: 21733195 PMCID: PMC3166902 DOI: 10.1186/1471-2296-12-70] [Citation(s) in RCA: 46] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/22/2010] [Accepted: 07/07/2011] [Indexed: 11/23/2022]
Abstract
BACKGROUND Non-steroidal anti-inflammatory (NSAID) medications are a common cause of reported adverse drug side-effects. This study describes the prevalence of non-steroidal anti-inflammatory (NSAID) use (other than low-dose aspirin) and the presence of co-existing relative contraindications to NSAID use and chronic conditions in a representative population sample. METHODS Data were analysed from 3,206 adults attending first follow-up of the North West Adelaide Health Study (NWAHS) in 2004-2006, a longitudinal representative population study. Medications were brought into study clinic visits by participants. Clinical assessment included measured blood pressure, kidney function, serum cholesterol, blood glucose. Questionnaires assessed demographics, lifestyle risk factors, physician-diagnosed chronic conditions. Data were weighted to census measures by region, age group, gender, and probability of selection in the household, to provide population representative estimates. Pearson's Chi-square tests determined significant differences in proportions. Multiple logistic regression was used to examine associations of socio-demographic characteristics with use of NSAIDs. RESULTS Of 3,175 participants, 357 (11.2%), and 16% of those aged > 55 years, reported using either non-specific NSAIDs or COX-2 inhibitors, other than low-dose aspirin. Among people using NSAIDs, 60.8% had hypertension, 30.8% had Stage 3 or higher chronic kidney disease, 17.2% had a history of cardiovascular disease (CVD) and 20.7% had a > 15% 10-year CVD risk. The prevalence of NSAID use among people with hypertension was 16%, with kidney disease 15.9%, and a history of CVD 20.0%. Among people taking diuretics, 24.1% were also taking NSAIDs, and of those taking medications for gastro-esophageal reflux, 24.7% were on NSAIDs. Prescription-only COX-2 inhibitors, but not other NSAIDs, were used more by people > 75 years than by 35-54 year olds (OR 3.7, 95% CI 2.0, 6.7), and also were more commonly used by people with hypertension, cardiac and kidney disease. CONCLUSIONS There is a high prevalence of current NSAID use among groups at-risk for significant drug-related adverse events or who have major chronic conditions that are relative contraindications to NSAID use. Assessment of absolute risks regarding cardiovascular and kidney disease need to take into account use of medications such as NSAIDs. The potential to make a substantial impact on chronic disease burden via improved use of NSAIDs is considerable.
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Affiliation(s)
- Robert J Adams
- The Health Observatory, University of Adelaide, The Queen Elizabeth Hospital Campus, Woodville Road, Woodville, SA, Australia
| | - Sarah L Appleton
- The Health Observatory, University of Adelaide, The Queen Elizabeth Hospital Campus, Woodville Road, Woodville, SA, Australia
| | - Tiffany K Gill
- Population Research & Outcomes Studies Unit, The University of Adelaide, Adelaide, SA, Australia
| | - Anne W Taylor
- Population Research & Outcomes Studies Unit, The University of Adelaide, Adelaide, SA, Australia
| | - David H Wilson
- The Health Observatory, University of Adelaide, The Queen Elizabeth Hospital Campus, Woodville Road, Woodville, SA, Australia
| | - Catherine L Hill
- The Health Observatory, University of Adelaide, The Queen Elizabeth Hospital Campus, Woodville Road, Woodville, SA, Australia
- Rheumatology Unit, The Queen Elizabeth Hospital, Woodville Road, Woodville, SA, Australia
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Inotai A, Hankó B, Mészáros Á. Trends in the non-steroidal anti-inflammatory drug market in six Central-Eastern European countries based on retail information. Pharmacoepidemiol Drug Saf 2009; 19:183-90. [DOI: 10.1002/pds.1893] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Current awareness: Pharmacoepidemiology and drug safety. Pharmacoepidemiol Drug Saf 2009. [DOI: 10.1002/pds.1646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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