The interference of polypharmacy and the importance of clinical pharmacy advice in the treatment of leprosy: a case-control study

Detalhes bibliográficos
Autor(a) principal: Cerqueira,Selma Regina Penha Silva
Data de Publicação: 2020
Outros Autores: 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
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.
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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
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dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0037-86822020000100326
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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
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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)
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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)
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