Abstract：
OBJECTIVE: Polypharmacy, drug-drug interactions (DDI) and related adverse drug reaction (ADR) are understudied in SSc. The aim of this work was to determine the prevalence and determinants of DDI and ADR in a real-life prospective cohort of SSc patients.
METHODS: We performed a retrospective analysis of the drug prescriptions of SSc patients admitted to the daily scleroderma clinic between January 2020 and April 2022. DDI were identified using 2 prescription analysis applications, and adjudicated related ADRs occurring during a one-year follow-up were reported. Risk factors for DDI and ADR were identified using multivariate analysis.
RESULTS: One hundred and eight SSc patients were included. The median number of medications per patient was 6 [4-9]. Seventy-one (65.7 %) patients had 5 or more medications, and 23 (21.3 %) had 10 or more. Seventy-two (66.7 %) patients had DDIs on their prescriptions at inclusion. Patients with DDIs had more medications than patients without DDIs (7 [5-10] versus 3 [2-5], p < 0.0001). Six (8.3) patients experienced ADRs during the one-year follow-up. Patients with ADRs had more medications (14 [10-18] versus 7 [5-10] p < 0.001) and more DDIs (12 [7-32] versus 3 [1-6]; p < 0.001) than patients without ADRs. Multivariate analysis confirmed that the number of prescribed medications was independently positively associated with DDIs (OR: 2.25 [1.52-3.32], p < 0.0001) as well as with ADRs (OR: 1.68 [1.17-2.40], p < 0.01).
CONCLUSIONS: SSc patients are significantly exposed to polypharmacy, DDIs and related ADRs, particularly in cases of severe illness, and especially if 5 or more medications are prescribed.
METHODS: We performed a retrospective analysis of the drug prescriptions of SSc patients admitted to the daily scleroderma clinic between January 2020 and April 2022. DDI were identified using 2 prescription analysis applications, and adjudicated related ADRs occurring during a one-year follow-up were reported. Risk factors for DDI and ADR were identified using multivariate analysis.
RESULTS: One hundred and eight SSc patients were included. The median number of medications per patient was 6 [4-9]. Seventy-one (65.7 %) patients had 5 or more medications, and 23 (21.3 %) had 10 or more. Seventy-two (66.7 %) patients had DDIs on their prescriptions at inclusion. Patients with DDIs had more medications than patients without DDIs (7 [5-10] versus 3 [2-5], p < 0.0001). Six (8.3) patients experienced ADRs during the one-year follow-up. Patients with ADRs had more medications (14 [10-18] versus 7 [5-10] p < 0.001) and more DDIs (12 [7-32] versus 3 [1-6]; p < 0.001) than patients without ADRs. Multivariate analysis confirmed that the number of prescribed medications was independently positively associated with DDIs (OR: 2.25 [1.52-3.32], p < 0.0001) as well as with ADRs (OR: 1.68 [1.17-2.40], p < 0.01).
CONCLUSIONS: SSc patients are significantly exposed to polypharmacy, DDIs and related ADRs, particularly in cases of severe illness, and especially if 5 or more medications are prescribed.
摘要：
目标：多药，在SSc中，药物-药物相互作用（DDI）和相关的药物不良反应（ADR）的研究不足。这项工作的目的是确定现实生活中SSc患者前瞻性队列中DDI和ADR的患病率和决定因素。
方法：我们对2020年1月至2022年4月每日硬皮病门诊收治的SSc患者的药物处方进行了回顾性分析。使用2种处方分析应用程序确定DDI，报告了在一年随访期间发生的裁定相关ADR。使用多变量分析确定DDI和ADR的危险因素。
结果：纳入108例SSc患者。每位患者的中位用药数量为6[4-9]。71例（65.7%）患者有5种或更多的药物，和23（21.3％）有10个或更多。72例(66.7%)患者在纳入时的处方上有DDI。有DDI的患者比没有DDI的患者有更多的药物（7[5-10]对3[2-5]，p<0.0001)。在一年的随访期间，有6名（8.3）患者出现了ADR。与没有ADR的患者相比，有ADR的患者有更多的药物（14[10-18]对7[5-10]p<0.001）和更多的DDI（12[7-32]对3[1-6]；p<0.001）。多因素分析证实，处方药物的数量与DDI独立正相关（OR：2.25[1.52-3.32]，p<0.0001)以及ADR(OR：1.68[1.17-2.40]，p<0.01)。
结论：SSc患者显著暴露于多重用药，DDI和相关的ADR，特别是在严重疾病的情况下，特别是如果开了5种或更多的药物。
方法：我们对2020年1月至2022年4月每日硬皮病门诊收治的SSc患者的药物处方进行了回顾性分析。使用2种处方分析应用程序确定DDI，报告了在一年随访期间发生的裁定相关ADR。使用多变量分析确定DDI和ADR的危险因素。
结果：纳入108例SSc患者。每位患者的中位用药数量为6[4-9]。71例（65.7%）患者有5种或更多的药物，和23（21.3％）有10个或更多。72例(66.7%)患者在纳入时的处方上有DDI。有DDI的患者比没有DDI的患者有更多的药物（7[5-10]对3[2-5]，p<0.0001)。在一年的随访期间，有6名（8.3）患者出现了ADR。与没有ADR的患者相比，有ADR的患者有更多的药物（14[10-18]对7[5-10]p<0.001）和更多的DDI（12[7-32]对3[1-6]；p<0.001）。多因素分析证实，处方药物的数量与DDI独立正相关（OR：2.25[1.52-3.32]，p<0.0001)以及ADR(OR：1.68[1.17-2.40]，p<0.01)。
结论：SSc患者显著暴露于多重用药，DDI和相关的ADR，特别是在严重疾病的情况下，特别是如果开了5种或更多的药物。
