The interference of polypharmacy and the importance of clinical pharmacy advice in the treatment of leprosy: a case-control study
Autor(a) principal: | |
---|---|
Data de Publicação: | 2020 |
Outros Autores: | , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Revista da Sociedade Brasileira de Medicina Tropical |
Texto Completo: | http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822020000100326 |
Resumo: | Abstract INTRODUCTION: Although supervised doses are essential for reducing leprosy treatment failure, the impact of specific drug interactions has rarely been assessed. This study aimed to estimate the risk of leprosy treatment suspension in patients receiving polypharmacy. METHODS We performed this case-control study in which the primary outcome was defined as the need to discontinue multibacillary leprosy treatment for at least one supervised dose, and the main risk factor was the detection of polypharmacy. Multivariate analysis by logistic regression was used for calculating odds ratio (OR). RESULTS: This study included 103 patients, of whom 43 needed to discontinue leprosy treatment (hemolysis = 26, hepatitis = 2, hemolysis associated with hepatitis = 6, and suspected treatment resistance = 9) and the rest did not. The severity of drug interactions had no effect on treatment discontinuation. Patients who used five or more drugs in addition to leprosy treatment had almost a 4-fold greater risk of treatment suspension (OR, 3.88; 95% confidence interval: 1.79-9.12; p < 0.001). The number of drugs used also positively influenced the occurrence of hemolysis (p < 0.001). No patient presented evidence of molecular resistance to rifampicin, dapsone, or ofloxacin treatment, as evidenced by genetic sequencing detection of rpoB, folp1, and gyrA mutations. CONCLUSIONS: Polypharmacy has deleterious effects on the already difficult-to-adhere-to treatment of leprosy and polypharmacy induces hemolysis. Additional measures must be taken to avoid the undesirable effects of inadequate polypharmacy. |
id |
SBMT-1_dfc0c40497cb8f355a32585754df93a7 |
---|---|
oai_identifier_str |
oai:scielo:S0037-86822020000100326 |
network_acronym_str |
SBMT-1 |
network_name_str |
Revista da Sociedade Brasileira de Medicina Tropical |
repository_id_str |
|
spelling |
The interference of polypharmacy and the importance of clinical pharmacy advice in the treatment of leprosy: a case-control studyLeprosyPolypharmacyTherapeuticsTreatment FailureAbstract INTRODUCTION: Although supervised doses are essential for reducing leprosy treatment failure, the impact of specific drug interactions has rarely been assessed. This study aimed to estimate the risk of leprosy treatment suspension in patients receiving polypharmacy. METHODS We performed this case-control study in which the primary outcome was defined as the need to discontinue multibacillary leprosy treatment for at least one supervised dose, and the main risk factor was the detection of polypharmacy. Multivariate analysis by logistic regression was used for calculating odds ratio (OR). RESULTS: This study included 103 patients, of whom 43 needed to discontinue leprosy treatment (hemolysis = 26, hepatitis = 2, hemolysis associated with hepatitis = 6, and suspected treatment resistance = 9) and the rest did not. The severity of drug interactions had no effect on treatment discontinuation. Patients who used five or more drugs in addition to leprosy treatment had almost a 4-fold greater risk of treatment suspension (OR, 3.88; 95% confidence interval: 1.79-9.12; p < 0.001). The number of drugs used also positively influenced the occurrence of hemolysis (p < 0.001). No patient presented evidence of molecular resistance to rifampicin, dapsone, or ofloxacin treatment, as evidenced by genetic sequencing detection of rpoB, folp1, and gyrA mutations. CONCLUSIONS: Polypharmacy has deleterious effects on the already difficult-to-adhere-to treatment of leprosy and polypharmacy induces hemolysis. Additional measures must be taken to avoid the undesirable effects of inadequate polypharmacy.Sociedade Brasileira de Medicina Tropical - SBMT2020-01-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822020000100326Revista da Sociedade Brasileira de Medicina Tropical v.53 2020reponame:Revista da Sociedade Brasileira de Medicina Tropicalinstname:Sociedade Brasileira de Medicina Tropical (SBMT)instacron:SBMT10.1590/0037-8682-0114-2020info:eu-repo/semantics/openAccessCerqueira,Selma Regina Penha SilvaSantos,Lais Sevilha dosMorelo,Elaine FariaSantos Júnior,Agenor de Castro Moreira dosSousa,Carlos Augusto Felipe deGonçalves,Renata TrindadeHans Neto,GunterMarques,Daniel da SilvaSampaio,Raimunda Nonata RibeiroKurizky,Patrícia ShuGomes,Ciro Martinseng2020-05-28T00:00:00Zoai:scielo:S0037-86822020000100326Revistahttps://www.sbmt.org.br/portal/revista/ONGhttps://old.scielo.br/oai/scielo-oai.php||dalmo@rsbmt.uftm.edu.br|| rsbmt@rsbmt.uftm.edu.br1678-98490037-8682opendoar:2020-05-28T00:00Revista da Sociedade Brasileira de Medicina Tropical - Sociedade Brasileira de Medicina Tropical (SBMT)false |
dc.title.none.fl_str_mv |
The interference of polypharmacy and the importance of clinical pharmacy advice in the treatment of leprosy: a case-control study |
title |
The interference of polypharmacy and the importance of clinical pharmacy advice in the treatment of leprosy: a case-control study |
spellingShingle |
The interference of polypharmacy and the importance of clinical pharmacy advice in the treatment of leprosy: a case-control study Cerqueira,Selma Regina Penha Silva Leprosy Polypharmacy Therapeutics Treatment Failure |
title_short |
The interference of polypharmacy and the importance of clinical pharmacy advice in the treatment of leprosy: a case-control study |
title_full |
The interference of polypharmacy and the importance of clinical pharmacy advice in the treatment of leprosy: a case-control study |
title_fullStr |
The interference of polypharmacy and the importance of clinical pharmacy advice in the treatment of leprosy: a case-control study |
title_full_unstemmed |
The interference of polypharmacy and the importance of clinical pharmacy advice in the treatment of leprosy: a case-control study |
title_sort |
The interference of polypharmacy and the importance of clinical pharmacy advice in the treatment of leprosy: a case-control study |
author |
Cerqueira,Selma Regina Penha Silva |
author_facet |
Cerqueira,Selma Regina Penha Silva Santos,Lais Sevilha dos Morelo,Elaine Faria Santos Júnior,Agenor de Castro Moreira dos Sousa,Carlos Augusto Felipe de Gonçalves,Renata Trindade Hans Neto,Gunter Marques,Daniel da Silva Sampaio,Raimunda Nonata Ribeiro Kurizky,Patrícia Shu Gomes,Ciro Martins |
author_role |
author |
author2 |
Santos,Lais Sevilha dos Morelo,Elaine Faria Santos Júnior,Agenor de Castro Moreira dos Sousa,Carlos Augusto Felipe de Gonçalves,Renata Trindade Hans Neto,Gunter Marques,Daniel da Silva Sampaio,Raimunda Nonata Ribeiro Kurizky,Patrícia Shu Gomes,Ciro Martins |
author2_role |
author author author author author author author author author author |
dc.contributor.author.fl_str_mv |
Cerqueira,Selma Regina Penha Silva Santos,Lais Sevilha dos Morelo,Elaine Faria Santos Júnior,Agenor de Castro Moreira dos Sousa,Carlos Augusto Felipe de Gonçalves,Renata Trindade Hans Neto,Gunter Marques,Daniel da Silva Sampaio,Raimunda Nonata Ribeiro Kurizky,Patrícia Shu Gomes,Ciro Martins |
dc.subject.por.fl_str_mv |
Leprosy Polypharmacy Therapeutics Treatment Failure |
topic |
Leprosy Polypharmacy Therapeutics Treatment Failure |
description |
Abstract INTRODUCTION: Although supervised doses are essential for reducing leprosy treatment failure, the impact of specific drug interactions has rarely been assessed. This study aimed to estimate the risk of leprosy treatment suspension in patients receiving polypharmacy. METHODS We performed this case-control study in which the primary outcome was defined as the need to discontinue multibacillary leprosy treatment for at least one supervised dose, and the main risk factor was the detection of polypharmacy. Multivariate analysis by logistic regression was used for calculating odds ratio (OR). RESULTS: This study included 103 patients, of whom 43 needed to discontinue leprosy treatment (hemolysis = 26, hepatitis = 2, hemolysis associated with hepatitis = 6, and suspected treatment resistance = 9) and the rest did not. The severity of drug interactions had no effect on treatment discontinuation. Patients who used five or more drugs in addition to leprosy treatment had almost a 4-fold greater risk of treatment suspension (OR, 3.88; 95% confidence interval: 1.79-9.12; p < 0.001). The number of drugs used also positively influenced the occurrence of hemolysis (p < 0.001). No patient presented evidence of molecular resistance to rifampicin, dapsone, or ofloxacin treatment, as evidenced by genetic sequencing detection of rpoB, folp1, and gyrA mutations. CONCLUSIONS: Polypharmacy has deleterious effects on the already difficult-to-adhere-to treatment of leprosy and polypharmacy induces hemolysis. Additional measures must be taken to avoid the undesirable effects of inadequate polypharmacy. |
publishDate |
2020 |
dc.date.none.fl_str_mv |
2020-01-01 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822020000100326 |
url |
http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822020000100326 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
10.1590/0037-8682-0114-2020 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
text/html |
dc.publisher.none.fl_str_mv |
Sociedade Brasileira de Medicina Tropical - SBMT |
publisher.none.fl_str_mv |
Sociedade Brasileira de Medicina Tropical - SBMT |
dc.source.none.fl_str_mv |
Revista da Sociedade Brasileira de Medicina Tropical v.53 2020 reponame:Revista da Sociedade Brasileira de Medicina Tropical instname:Sociedade Brasileira de Medicina Tropical (SBMT) instacron:SBMT |
instname_str |
Sociedade Brasileira de Medicina Tropical (SBMT) |
instacron_str |
SBMT |
institution |
SBMT |
reponame_str |
Revista da Sociedade Brasileira de Medicina Tropical |
collection |
Revista da Sociedade Brasileira de Medicina Tropical |
repository.name.fl_str_mv |
Revista da Sociedade Brasileira de Medicina Tropical - Sociedade Brasileira de Medicina Tropical (SBMT) |
repository.mail.fl_str_mv |
||dalmo@rsbmt.uftm.edu.br|| rsbmt@rsbmt.uftm.edu.br |
_version_ |
1752122162075926528 |