Assessment of interactions and dosage recommendations of synthetic DMARDs - evidence-based and consensus-based recommendations based on a systematic literature search
Conventional synthetic (cs) and targeted synthetic (ts) disease-modifying antirheumatic drugs (DMARD) have potential interactions with a multitude of drugs. Furthermore, they sometimes have a lower therapeutic index, particularly in cases of limited organ functions. The aim of this work was to estab...
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| Hauptverfasser: | , , , , |
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| Dokumenttyp: | Article (Journal) |
| Sprache: | Englisch |
| Veröffentlicht: |
2024
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| In: |
Zeitschrift für Rheumatologie
Year: 2024, Jahrgang: 83, Pages: 8-19 |
| ISSN: | 1435-1250 |
| DOI: | 10.1007/s00393-023-01417-3 |
| Online-Zugang: | Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1007/s00393-023-01417-3
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| Verfasserangaben: | C. Fiehn, J. Leipe, C. Weseloh, R. Bergner, K. Krüger |
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| 520 | |a Conventional synthetic (cs) and targeted synthetic (ts) disease-modifying antirheumatic drugs (DMARD) have potential interactions with a multitude of drugs. Furthermore, they sometimes have a lower therapeutic index, particularly in cases of limited organ functions. The aim of this work was to establish evidence-based recommendations on the therapeutic use of DMARDs in the context of drug interactions and dosage recommendations. A systematic literature search was carried out on the issue of drug interactions and dosages in cases of patients with limited kidney function and higher age and suffering from rheumatoid arthritis. A total of 2756 scientific publications were screened and 154 selected of which 68 were scrutinized in detail. Furthermore, the respective product information was also analyzed. A multitude of possible interactions of synthetic DMARDs with different drugs were detected, which were then assessed with respect to the clinical significance and consequences. A consensus process led to making recommendations with which the interactions were classified: A: dangerous combination, B: avoid combination (if possible, pausing DMARD treatment), C: possible combination requiring increased monitoring and potential adjustments in dosage and D: pharmacological interaction without relevance in DMARD standard doses. Apart from that dosage recommendations were established for each csDMARD and tsDMARD depending on kidney function and age. There are 3 primary recommendations and 11 core recommendations on interactions and dosages of csDMARDs and tsDMARDs meant as a practical help for therapeutic decision making and to improve safety in the treatment of rheumatoid arthritis. | ||
| 650 | 4 | |a Arzneimittelinteraktionen | |
| 650 | 4 | |a Disease-modifying antirheumatic drugs | |
| 650 | 4 | |a Drug interactions | |
| 650 | 4 | |a Janus kinase inhibitors | |
| 650 | 4 | |a Januskinaseinhibitoren | |
| 650 | 4 | |a Pharmacology | |
| 650 | 4 | |a Pharmakologie | |
| 650 | 4 | |a Rheumatoid arthritis | |
| 650 | 4 | |a Rheumatoide Arthritis | |
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