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Lalagkas PN, Polyzois S, Papanas N, Nena E, Vourli N, Kontogiorgis C, Constantinides T. Prevalence of pharmacologically treated type 2 diabetes mellitus in 2012-2016 in Greece: Real-World Data. Prim Care Diabetes 2022; 16:714-716. [PMID: 35927164 DOI: 10.1016/j.pcd.2022.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 06/10/2022] [Accepted: 07/13/2022] [Indexed: 01/15/2023]
Abstract
Type 2 diabetes mellitus is a serious health disorder with a global prevalence of 6059 cases per 100,000 in 2017. By analyzing real-world data, our study found an increasing prevalence of type 2 diabetes in Greece, with the peak being 7,40 individuals per 100,000 in 2016.
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Affiliation(s)
| | - Spyros Polyzois
- Laboratory of Hygiene and Environmental Protection, Democritus University of Thrace, Alexandroupolis, Greece
| | - Nikolaos Papanas
- Diabetes Centre-Diabetic Foot Clinic, Second Department of Internal Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Evangelia Nena
- Laboratory of Hygiene and Environmental Protection, Democritus University of Thrace, Alexandroupolis, Greece
| | - Nemi Vourli
- Laboratory of Hygiene and Environmental Protection, Democritus University of Thrace, Alexandroupolis, Greece
| | - Christos Kontogiorgis
- Laboratory of Hygiene and Environmental Protection, Democritus University of Thrace, Alexandroupolis, Greece.
| | - Theodoros Constantinides
- Laboratory of Hygiene and Environmental Protection, Democritus University of Thrace, Alexandroupolis, Greece
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2
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Pereira LR, Durán CE, Layton D, Poulentzas G, Lalagkas PN, Kontogiorgis C, Sturkenboom M. Correction to: A Landscape Analysis of Post-Marketing Studies Registered in the EU PAS Register and ClinicalTrials.gov Focusing on Pregnancy Outcomes or Breastfeeding Effects: A Contribution from the ConcePTION Project. Drug Saf 2022; 45:399. [PMID: 35411472 PMCID: PMC9021099 DOI: 10.1007/s40264-022-01178-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Leonardo Roque Pereira
- Department of Data Science & Biostatistics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - Carlos E Durán
- Department of Data Science & Biostatistics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Georgios Poulentzas
- Laboratory of Hygiene and Environmental Protection, Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Panagiotis-Nikolaos Lalagkas
- Laboratory of Hygiene and Environmental Protection, Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Christos Kontogiorgis
- Laboratory of Hygiene and Environmental Protection, Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Miriam Sturkenboom
- Department of Data Science & Biostatistics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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3
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Roque Pereira L, Durán CE, Layton D, Poulentzas G, Lalagkas PN, Kontogiorgis C, Sturkenboom M. A Landscape Analysis of Post-Marketing Studies Registered in the EU PAS Register and ClinicalTrials.gov Focusing on Pregnancy Outcomes or Breastfeeding Effects: A Contribution from the ConcePTION Project. Drug Saf 2022; 45:333-344. [PMID: 35357659 PMCID: PMC9021095 DOI: 10.1007/s40264-022-01154-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2022] [Indexed: 11/30/2022]
Abstract
Introduction A large proportion of medicine product labels lack information on safety in pregnancy and breastfeeding. To address this gap, pharmaceutical companies are requested to develop post-approval studies regarding the use of drugs by pregnant and breastfeeding women. Objective Our study aims to review key features of observational studies in pregnancy and breastfeeding and their impact on the respective medicine product labels. Methods Observational studies focusing on the safety evaluation of medicines used during pregnancy and breastfeeding were selected from the European Union Register of Post-Authorization Studies (EU PAS register) and ClinicalTrials.gov. We extracted information on the variables of interest and performed an impact assessment on the respective label. Results A total of 141 observational studies were eligible. Of these, 63 studies (45%) were based on primary data collection and 55 studies (39%) on secondary use of health data. A small number of studies (8%) aimed to evaluate drug safety during breastfeeding. Studies using secondary data collection lasted around 2.9 years as opposed to 7.5 years’ duration for studies using primary data collection. Only two product labels were updated based on the study results. Conclusion The duration is significantly longer for studies based on primary data collection, and these are also smaller in size (less power), whereas outcomes of interest are similar. For completed studies, the impact on the label was very low. Given the gap in adequate pregnancy information on product labels, the current process of generating evidence in pregnancy and breastfeeding seems neither efficient nor impactful. To support evidence-based decision making by prescribers, this current process might be redesigned. Supplementary Information The online version contains supplementary material available at 10.1007/s40264-022-01154-7.
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Affiliation(s)
- Leonardo Roque Pereira
- Department of Data Science & Biostatistics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
| | - Carlos E Durán
- Department of Data Science & Biostatistics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Georgios Poulentzas
- Laboratory of Hygiene and Environmental Protection, Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Panagiotis-Nikolaos Lalagkas
- Laboratory of Hygiene and Environmental Protection, Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Christos Kontogiorgis
- Laboratory of Hygiene and Environmental Protection, Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Miriam Sturkenboom
- Department of Data Science & Biostatistics, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
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Sultana J, Crisafulli S, Almas M, Antonazzo IC, Baan E, Bartolini C, Bertuccio MP, Bonifazi F, Capuano A, Didio A, Ehrenstein V, Felisi M, Ferrajolo C, Fontana A, Francisca R, Fourrier-Reglat A, Fortuny J, Gini R, Hyeraci G, Hoeve C, Kontogiorgis C, Isgrò V, Lalagkas PN, L'Abbate L, Layton D, Landi A, Narduzzi S, Pereira LR, Poulentzas G, Rafaniello C, Roberto G, Scondotto G, Sportiello L, Toma M, Toussi M, Verhamme K, Volpe E, Trifirò G. Overview of the EU PAS register post-authorization studies performed in Europe from September 2010 to December 2018. Pharmacoepidemiol Drug Saf 2022; 31:689-705. [PMID: 35092329 PMCID: PMC9303697 DOI: 10.1002/pds.5413] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 12/09/2021] [Accepted: 01/24/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND The European post-authorisation study (EU PAS) register is a repository launched in 2010 by the European Medicines Agency (EMA). All EMA-requested PAS, commonly observational studies, must be recorded in this register. Multi-database studies (MDS) leveraging secondary data have become an important strategy to conduct PAS in recent years, as reflected by the type of studies registered in the EU PAS register. OBJECTIVES To analyse and describe PAS in the EU PAS register, with focus on MDS. METHODS Studies in the EU PAS register from inception to 31st December 2018 were described concerning transparency, regulatory obligations, scope, study type (e.g. observational study, clinical trial, survey, systematic review/meta-analysis), study design, type of data collection and target population. MDS were defined as studies conducted through secondary use of >1 data source not linked at patient-level. Data extraction was carried out independently by 14 centres with expertise in pharmacoepidemiology, using publicly available information in the EU PAS register including study protocol, whenever available, using a standardised data collection form. For validation purposes, a second revision of key fields for a 15% random sample of studies was carried out by a different centre. The inter-rater reliability (IRR) was then calculated. Finally, to identify predictors of primary data collection-based studies /vs those based on secondary use of healthcare databases) or MDS (vs. non-MDS), odds ratios (OR) and 95% confidence intervals (CI) were calculated fitting univariate logistic regression models. RESULTS Overall, 1,426 studies were identified. Clinical trials (N=30; 2%), systematic reviews/meta-analyses (N=16; 1%) and miscellaneous study designs (N=46; 3%) were much less common than observational studies (N=1,227; 86%). The protocol was available for 63% (N=360) of 572 observational studies requested by a competent authority. Overall, 36% (N=446) of observational studies were based fully or partially on primary data collection. Of 757 observational studies based on secondary use of data alone, 282 (37%) were MDS. Drug utilisation was significantly more common as a study scope in MDS compared to non-MDS studies. The overall percentage agreement among collaborating centres that collected the data concerning study variables was highest for study type (93.5%) and lowest for type of secondary data (67.8%). CONCLUSIONS Observational studies were the most common type of studies in the EU PAS register, but 30% used primary data, which is more resource-intensive. Almost half of observational studies using secondary data were MDS. Data recording in the EU PAS register may be improved further, including more widespread availability of study protocols to improve transparency.
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Affiliation(s)
- Janet Sultana
- Pharmacy Department, Mater Dei Hospital, Malta.,Exeter College of Medicine and Health, Exeter
| | - Salvatore Crisafulli
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Mariana Almas
- Real World Solutions Department, IQVIA, Lisbon, Portugal
| | - Ippazio Cosimo Antonazzo
- Research Centre on Public Health (CESP), University of Milan-Bicocca, Milan, Italy.,Agenzia Regionale di Sanità della Toscana, Florence, Italy
| | - Esme Baan
- Department of Medical Informatics, Erasmus Medical Centre, Rotterdam, The Netherlands
| | | | - Maria Paola Bertuccio
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Fedele Bonifazi
- TEDDY European Network of Excellence for Paediatric Clinical Research, Pavia, Italy.,Fondazione per la Ricerca Farmacologica Gianni Benzi Onlus, Bari, Italy
| | - Annalisa Capuano
- Department of Experimental Medicine, University of Campania "Vanvitelli", Naples, Italy.,Campania Regional Center of Pharmacovigilance and Pharmacoepidemiology, Naples, Italy
| | - Antonella Didio
- TEDDY European Network of Excellence for Paediatric Clinical Research, Pavia, Italy.,Fondazione per la Ricerca Farmacologica Gianni Benzi Onlus, Bari, Italy
| | - Vera Ehrenstein
- Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark
| | - Mariagrazia Felisi
- TEDDY European Network of Excellence for Paediatric Clinical Research, Pavia, Italy.,CVBF Consorzio per Valutazioni Biologiche e Farmacologiche, Pavia, Italy
| | - Carmen Ferrajolo
- Department of Experimental Medicine, University of Campania "Vanvitelli", Naples, Italy.,Campania Regional Center of Pharmacovigilance and Pharmacoepidemiology, Naples, Italy
| | - Andrea Fontana
- Unit of Biostatistics, Fondazione IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy
| | - Remy Francisca
- Department of Medical Informatics, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Annie Fourrier-Reglat
- Univ. Bordeaux, INSERM, Bordeaux Population Health Research Center, Team of Pharmacoepidemiology, UMR 1219, Bordeaux, France
| | | | - Rosa Gini
- Agenzia Regionale di Sanità della Toscana, Florence, Italy
| | - Giulia Hyeraci
- Agenzia Regionale di Sanità della Toscana, Florence, Italy
| | - Christel Hoeve
- Department of Medical Informatics, Erasmus Medical Centre, Rotterdam, The Netherlands
| | | | - Valentina Isgrò
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | | | - Luca L'Abbate
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Deborah Layton
- Data Science Hub, Real World Solutions, IQVIA, London, United Kingdom
| | - Annalisa Landi
- TEDDY European Network of Excellence for Paediatric Clinical Research, Pavia, Italy.,Fondazione per la Ricerca Farmacologica Gianni Benzi Onlus, Bari, Italy
| | - Silvia Narduzzi
- Data Science Hub, Real World Solutions, IQVIA, London, United Kingdom
| | - Leonardo Roque Pereira
- University Medical Center Utrecht, Department of Datascience & Biostatistics, Utrecht, the Netherlands
| | | | - Concetta Rafaniello
- Department of Experimental Medicine, University of Campania "Vanvitelli", Naples, Italy.,Campania Regional Center of Pharmacovigilance and Pharmacoepidemiology, Naples, Italy
| | | | - Giulia Scondotto
- Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, Messina, Italy
| | - Liberata Sportiello
- Department of Experimental Medicine, University of Campania "Vanvitelli", Naples, Italy.,Campania Regional Center of Pharmacovigilance and Pharmacoepidemiology, Naples, Italy
| | - Maddalena Toma
- TEDDY European Network of Excellence for Paediatric Clinical Research, Pavia, Italy.,Fondazione per la Ricerca Farmacologica Gianni Benzi Onlus, Bari, Italy
| | - Massoud Toussi
- Data Science Hub, Real World Solutions, IQVIA, London, United Kingdom
| | - Katia Verhamme
- Department of Medical Informatics, Erasmus Medical Centre, Rotterdam, The Netherlands
| | - Elisabetta Volpe
- TEDDY European Network of Excellence for Paediatric Clinical Research, Pavia, Italy.,Fondazione per la Ricerca Farmacologica Gianni Benzi Onlus, Bari, Italy
| | - Gianluca Trifirò
- Department of Diagnostics and Public Health, University of Verona, Verona, Italy
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Lalagkas PN, Poulentzas G, Takaviti A, Toursidou Z, Tatsiou T, Hadjipavlou-Litina D, Wettermark B, Kontogiorgis C, Constantinides T. Community Attitudes and Habits Toward Over-The-Counter Drugs: Results of a Study Conducted in Thessaloniki, Greece. Value Health Reg Issues 2021; 28:38-45. [PMID: 34800830 DOI: 10.1016/j.vhri.2021.07.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 04/13/2021] [Accepted: 07/21/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To determine the frequency of use, sources of information, and selection criteria of Greek residents regarding over-the-counter (OTC) drugs, as well as their opinion about their dispensing in nonpharmacy settings. METHODS This was a survey study in which an anonymous cross-sectional questionnaire was used to assess the knowledge, habits, and attitudes about OTC drugs. Data were collected from March 2017 to July 2017 in Thessaloniki, the second largest city in Greece. Logistic regression was used to investigate significant factors that affect the participants' behavior. RESULTS A total of 782 participants completed the questionnaire. The population had a mean (SD) age of 46 (17) years and 55.1% were females. About one-third (32.5%) of the participants used nonsteroidal anti-inflammatory drugs more than once per week. OTC drugs acting on the gastrointestinal tract were used to a lower extent (13.2%). The majority (84%) of the respondents consult a healthcare professional about the information on OTC drugs. Furthermore, when not sure about which OTC drug to use, 510 participants (65.6%) valued their physician's advice, whereas 480 participants (60.2%) valued their pharmacist's advice. Most participants (61.2%) were negatively inclined toward the purchase of OTC drugs in nonpharmacy settings, with younger participants being more receptive to out-of-pharmacy OTC drug purchase than older ones (odds ratio 2.20; 95% confidence interval 1.37-3.54). CONCLUSIONS Healthcare professionals play an important role in providing people information on their selection of OTC drugs. This could be the main reason why participants prefer to buy OTC drugs from community pharmacies rather than retail shops.
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Affiliation(s)
- Panagiotis-Nikolaos Lalagkas
- Laboratory of Hygiene and Environmental Protection, Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Georgios Poulentzas
- Laboratory of Hygiene and Environmental Protection, Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Anna Takaviti
- Division of Pharmaceutical Chemistry, Department of Pharmacy, Aristotle University of Thessaloniki, Greece
| | - Zaklin Toursidou
- Division of Pharmaceutical Chemistry, Department of Pharmacy, Aristotle University of Thessaloniki, Greece
| | - Theodora Tatsiou
- Division of Pharmaceutical Chemistry, Department of Pharmacy, Aristotle University of Thessaloniki, Greece
| | - Dimitra Hadjipavlou-Litina
- Division of Pharmaceutical Chemistry, Department of Pharmacy, Aristotle University of Thessaloniki, Greece
| | - Björn Wettermark
- Department of Pharmacy, Disciplinary Domain of Medicine and Pharmacy, Uppsala University, Uppsala, Sweden
| | - Christos Kontogiorgis
- Laboratory of Hygiene and Environmental Protection, Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece.
| | - Theodoros Constantinides
- Laboratory of Hygiene and Environmental Protection, Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
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Lalagkas PN, Poulentzas G, Tsiolis L, Berberoglou E, Hadjipavlou-Litina D, Douros A, Kontogiorgis C, Constantinides T. Investigating Potential Drug-Drug Interactions from Greek e-Prescription Data. Curr Drug Saf 2021; 17:114-120. [PMID: 34397333 DOI: 10.2174/1574886316666210816115811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 05/24/2021] [Accepted: 06/15/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND The prevalence of potential drug-drug interactions (pDDIs) is indicative of the prevalence of actual drug-drug interactions and prescription quality. However, they are significantly understudied in Greece. OBJECTIVE To determine the prevalence of pDDIs among outpatients and identify factors associated with their occurrence. METHODS Anonymous e-prescription data between 2012 and 2017 were obtained from community pharmacies in Thessaloniki, Greece. Patients taking more than one medication for at least three months were included. pDDIs were identified and categorized depending on their clinical significance using Drug Interactions Checker. Crude and adjusted odds ratios (ORs) with accompanying 95% confidence intervals (CIs) of risk factors of pDDIs occurrence were identified using multivariable logistic regression. RESULTS During the study period, 6,000 anonymous e-prescriptions (1,000 per year) satisfying the inclusion criteria, were collected. The overall prevalence of major pDDIs was 17.4% (63.0% for moderate pDDIs). The most common major pDDIs were between amlodipine and simvastatin (22.8% of major interactions) followed by clopidogrel and omeprazole (6.4% of major interactions). Polypharmacy (≥5 concomitantly received medications) was associated with an increased risk of major pDDIs (adjusted OR, 5.72; 95% CI, 4.87-6.72); no associations were observed regarding age, sex and number of prescribing physicians. CONCLUSION The prevalence of pDDIs in this study was higher than previously reported in other European countries, with polypharmacy being a potential risk factor. Those results argue for a need for improvement in the area of prescribing in Greece.
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Affiliation(s)
- Panagiotis-Nikolaos Lalagkas
- Laboratory of Hygiene and Environmental Protection, Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Georgios Poulentzas
- Laboratory of Hygiene and Environmental Protection, Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Lampros Tsiolis
- Division of Pharmaceutical Chemistry, Department of Pharmacy, Aristotle University of Thessaloniki, Greece
| | - Eleftherios Berberoglou
- Laboratory of Hygiene and Environmental Protection, Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Dimitra Hadjipavlou-Litina
- Division of Pharmaceutical Chemistry, Department of Pharmacy, Aristotle University of Thessaloniki, Greece
| | - Antonios Douros
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada
| | - Christos Kontogiorgis
- Laboratory of Hygiene and Environmental Protection, Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Theodoros Constantinides
- Laboratory of Hygiene and Environmental Protection, Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
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Lalagkas PN, Poulentzas G, Kontogiorgis C, Douros A. Potential drug-drug interaction between sodium-glucose co-transporter 2 inhibitors and statins: pharmacological and clinical evidence. Expert Opin Drug Metab Toxicol 2021; 17:697-705. [PMID: 33888031 DOI: 10.1080/17425255.2021.1921735] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Recent case reports suggested that concomitant use of sodium-glucose co-transporter 2 (SGLT2) inhibitors with statins could lead to increased statin toxicity. We provide a comprehensive overview of the available pharmacological and clinical evidence on this potential drug-drug interaction (DDI). AREAS COVERED We searched MEDLINE PubMed until November 2020 for (i) pharmacokinetic studies on SGLT2 inhibitors, statins, and their potential interaction, and (ii) case reports and clinical studies assessing the safety of concomitant use of SGLT2 inhibitors and statins. We also searched regulatory documents submitted to the United States Food and Drug Administration for unpublished data on this potential DDI. EXPERT OPINION SGLT2 inhibitors are increasingly used for type 2 diabetes, chronic heart failure, and chronic kidney disease, and concomitant use with statins is common given the comorbidity of indications. While pharmacokinetic studies in healthy subjects showed no clinically relevant changes in statin levels during SGLT2 inhibitor co-administration, the published case reports and pharmacologic reasoning support the possibility of an interaction. Underlying mechanisms could be pharmacokinetic or pharmacodynamic, and canagliflozin appears to be the SGLT2 inhibitor with the highest interaction potential. Further research including 'real-world' pharmacoepidemiologic studies is needed to better understand the clinical significance of this DDI.
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Affiliation(s)
- Panagiotis-Nikolaos Lalagkas
- Laboratory of Hygiene and Environmental Protection, Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Georgios Poulentzas
- Laboratory of Hygiene and Environmental Protection, Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece
| | - Christos Kontogiorgis
- Laboratory of Hygiene and Environmental Protection, Department of Medicine, Democritus University of Thrace, Alexandroupolis, Greece.,Institute of Agri-Food and Life Sciences, Hellenic Mediterranean University Research Centre, Heraklion, Greece
| | - Antonios Douros
- Centre for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, QC, Canada.,Departments of Medicine and Epidemiology, McGill University, Montreal, QC, Canada.,Institute of Clinical Pharmacology and Toxicology, Charité - Universitätsmedizin Berlin, Berlin, Germany
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