ＨＭＧ‐ＣｏＡ還元酵素阻害剤アトルバスタチンの投与量および副作用発現を指標としたチトクロームＰ４５０代謝情報に基づく薬物相互作用推測データベースの臨床上の有用性
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概要
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We created a new database (CYP database) to predict drug-drug interactions based Cytochrome P-450-related metabolic information and then evaluated the clinical effect of the concurrent administration of drugs that are not noted as contraindicated or requiring caution when co-administered with atorvastatin in package inserts, but are listed as requiring caution in concomitant administration in the CYP database, based on the dosage and adverse events of atorvastatin. We collected information on mean dosage and adverse events for 142 patients taking atorvastatin out of the 10,018 patients targeted. The mean administered dosage of atorvastatin for the group receiving combinations requiring caution according to the database was 8.3 mg, less than the 9.2 mg mean dosage for the group not taking combinations requiring caution. The occurrence of adverse events for the groups taking atorvastatin with other drugs requiring caution as listed in the package insert, and the CYP database were 8.3 and 8.5%, respectively, (relative risks 3.07 and 3.15, respectively) much higher than the 2.7% adverse event rate for the group not taking drugs requiring caution together with atorvastatin. The rate for adverse events in the case of the group taking combinations listed as requiring caution in both the package insert and CYP database was 22.2%, and the relative risk was 8.22, both high rates. On the basis of these results, information on combinations requiring caution from the CYP database is clinically as useful as that from the package insert.
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