Analysis of drug–drug interactions among patients receiving antiretroviral regimens using data from a large open-source prescription database

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Purpose.Results of a study of contraindicated concomitant medication use among recipients of preferred antiretroviral therapy (ART) regimens are reported.Methods.A retrospective study was conducted to evaluate concomitant medication use in a cohort of previously treatment-naive, human immunodeficiency virus (HIV)–infected U.S. patients prescribed preferred ART regimens during the period April 2014–March 2015. Data were obtained from a proprietary longitudinal prescription database; elements retrieved included age, sex, and prescription data. The outcome of interest was the frequency of drug–drug interactions (DDIs) associated with concomitant use of contraindicated medications.Results.Data on 25,919 unique treatment-naive patients who used a preferred ART regimen were collected. Overall, there were 384 instances in which a contraindicated medication was dispensed for concurrent use with a recommended ART regimen. Rates of contraindicated concomitant medication use differed significantly by ART regimen; the highest rate (3.2%) was for darunavir plus ritonavir plus emtricitabine–tenofovir disoproxil fumarate (DRV plus RTV plus FTC/TDF), followed by elvitegravir–cobicistat–emtricitabine–tenofovir disoproxil fumarate (EVG/c/FTC/TDF)(2.8%). The highest frequencies of DDIs were associated with ART regimens that included a pharmacoenhancing agent: DRV plus RTV plus FTC/TDF (3.2%) and EVG/c/FTC/TDF (2.8%).Conclusion.In a large population of treatment-naive HIV-infected patients, ART regimens that contained a pharmacoenhancing agent were involved most frequently in contraindicated medication–related DDIs. All of the DDIs could have been avoided by using therapeutic alternatives within the same class not associated with a DDI.

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