title: Potential drug-drug interactions with abiraterone in metastatic castration-resistant prostate cancer patients: a prevalence study in France.
abstract: OBJECTIVE
  Abiraterone acetate combined with prednisone improves survival in metastatic castration-resistant prostate cancer (mCRPC) patients. This oral anticancer agent may result in drug-drug interactions (DDI). We aimed to evaluate the prevalence of DDI with abiraterone and the possible determinants for the occurrence of these DDI.
  
  
  METHODS
  We performed a single centre retrospective review from electronic medical records of mCRPC patients treated with abiraterone from 2011 to 2015. Potential DDI with abiraterone were identified using Micromedex and were categorized by a 4-point scale severity.
  
  
  RESULTS
  Seventy-two out of ninety-five mCRPC pts (median age: 77 years [68-82]) had comorbidities. The median number of drugs used per patient was 7 [5-9]. 66 potential DDI with abiraterone were detected in 49 patients (52%): 39 and 61% were classified as major and moderate DDI, respectively. In the univariate analysis, pain (p < 0.0001), hypo-albuminemia (p = 0.032), and higher ECOG performance status (PS) (p = 0.013) were significantly associated with a higher risk of DDI with abiraterone. Pain (p < 0.0001) and PS (p = 0.018) remained significant in the multivariate analysis.
  
  
  CONCLUSIONS
  Polypharmacy is an issue among mCRPC patients. In our study, half of the patients have potential DDI with abiraterone. Patients with pain and poor PS are at higher risk of DDI with abiraterone. A medication review by a pharmacist is of crucial importance to prevent DDI with abiraterone.
authors.affiliation: Assistance publique des Hôpitaux de Paris, Service de Cancérologie médicale, Hôpital Cochin, Paris, France.
authors.forename: Clément
authors.initials: C
authors.lastname: Bonnet
authors.affiliation: Assistance publique des Hôpitaux de Paris, Service de Cancérologie médicale, Hôpital Cochin, Paris, France.
authors.forename: Pascaline
authors.initials: P
authors.lastname: Boudou-Rouquette
authors.affiliation: Assistance publique des Hôpitaux de Paris, Unité Fonctionnelle de Pharmacocinétique et Pharmacochimie, Hôpital Cochin, Paris, France.
authors.forename: Esther
authors.initials: E
authors.lastname: Azoulay-Rutman
authors.affiliation: Assistance publique des Hôpitaux de Paris, Service de Cancérologie médicale, Hôpital Cochin, Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Huillard
authors.affiliation: Assistance publique des Hôpitaux de Paris, Département de Biostatistiques, Hôpital Pitié- Salpétrière, Paris, France.
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Golmard
authors.affiliation: Assistance publique des Hôpitaux de Paris, Service de Cancérologie médicale, Hôpital Cochin, Paris, France.
authors.forename: Edith
authors.initials: E
authors.lastname: Carton
authors.affiliation: Assistance publique des Hôpitaux de Paris, Unité Fonctionnelle de Pharmacocinétique et Pharmacochimie, Hôpital Cochin, Paris, France.
authors.forename: Gaëlle
authors.initials: G
authors.lastname: Noé
authors.affiliation: Assistance publique des Hôpitaux de Paris, Unité Fonctionnelle de Pharmacocinétique et Pharmacochimie, Hôpital Cochin, Paris, France.|UMR8638 CNRS, UFR De Pharmacie, Université Paris Descartes, PRES Sorbonne Paris Cité, Paris, France.
authors.forename: Michel
authors.initials: M
authors.lastname: Vidal
authors.affiliation: Service de Gériatrie, Hôpital Broca, Hôpitaux Paris Centre, Université Paris Descartes, Paris, France.
authors.forename: Galdric
authors.initials: G
authors.lastname: Orvoen
authors.affiliation: Service de Gériatrie, Hôpital Broca, Hôpitaux Paris Centre, Université Paris Descartes, Paris, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Chah Wakilian
authors.affiliation: Assistance publique des Hôpitaux de Paris, Service de Cancérologie médicale, Hôpital Cochin, Paris, France.
authors.forename: Clémentine
authors.initials: C
authors.lastname: Villeminey
authors.affiliation: Assistance publique des Hôpitaux de Paris, Unité Fonctionnelle de Pharmacocinétique et Pharmacochimie, Hôpital Cochin, Paris, France.
authors.forename: Benoit
authors.initials: B
authors.lastname: Blanchet
authors.affiliation: Assistance publique des Hôpitaux de Paris, Service de Cancérologie médicale, Hôpital Cochin, Paris, France.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Alexandre
authors.affiliation: Assistance publique des Hôpitaux de Paris, Service de Cancérologie médicale, Hôpital Cochin, Paris, France.
authors.forename: François
authors.initials: F
authors.lastname: Goldwasser
authors.affiliation: Assistance publique des Hôpitaux de Paris, Unité Fonctionnelle de Pharmacocinétique et Pharmacochimie, Hôpital Cochin, Paris, France. schoemann.audrey@gmail.com.|UMR8638 CNRS, UFR De Pharmacie, Université Paris Descartes, PRES Sorbonne Paris Cité, Paris, France. schoemann.audrey@gmail.com.
authors.forename: Audrey
authors.initials: A
authors.lastname: Thomas-Schoemann
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000736:Androstenes / Q000009:adverse effects* / Q000627:therapeutic use; D015897:Comorbidity; D003430:Cross-Sectional Studies; D018572:Disease-Free Survival; D004347:Drug Interactions; D057286:Electronic Health Records; D004791:Enzyme Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D009362:Neoplasm Metastasis; D010146:Pain / Q000139:chemically induced / Q000453:epidemiology; D010595:Pharmacists; D019338:Polypharmacy; D015995:Prevalence; D064129:Prostatic Neoplasms, Castration-Resistant / Q000188:drug therapy* / Q000453:epidemiology*; D012189:Retrospective Studies
chemical_list: D000736:Androstenes; D004791:Enzyme Inhibitors; C089740:abiraterone
keywords: Abiraterone; Drug–drug interactions; Pharmacist; Prevalence; Prostate cancer