Association between concomitant use of hydrochlorothiazide and adverse chemotherapy-related events among older women with breast cancer treated with cyclophosphamide

Details

• Alternative Title:
  Cancer Epidemiol Biomarkers Prev
• Personal Author:
  Hsu, Christine D. ; Hinton, Sharon Peacock ; Reeder-Hayes, Katherine E. ; Sanoff, Hanna K. ; Lund, Jennifer L.
• Description:
  Background:
  
  The pharmacy reference database, Micromedex, lists concomitant hydrochlorothiazide and cyclophosphamide use as a potential major drug-drug-interaction (DDI) although only one small, single center study supports this claim. Our objective was to estimate associations between this potential DDI and two adverse chemotherapy-related events, neutropenia-related hospitalizations and treatment regimen discontinuation, among a cohort of women with breast cancer initiating adjuvant chemotherapy containing cyclophosphamide.
  
  Methods:
  
  Using linked Surveillance, Epidemiology, and End Results program (SEER)-Medicare data, we included women 66 years and older with breast cancer diagnosis between 2007-2011 who initiated a regimen containing cyclophosphamide. Risk ratios (RRs) and 95% confidence intervals for adverse outcomes comparing women exposed versus unexposed to the potential DDI were assessed using modified multivariable Poisson regression adjusting for potential confounders.
  
  Results:
  
  In total, 27% of women receiving cyclophosphamide treatment were exposed to concomitant hydrochlorothiazide, of which 11% experienced a neutropenia-related hospitalization and 21% discontinued their chemotherapy regimen prior to completion. Adjusted risks of both adverse events were similar between those exposed and unexposed to the potential DDI (neutropenia-related hospitalization: adjusted RR=0.92 (0.70, 1.21); treatment discontinuation: aRR=1.00 (0.96, 1.05)).
  
  Conclusions:
  
  Our results do not support an association between concomitant hydrochlorothiazide use and two clinically relevant adverse chemotherapy-related events.
  
  Impact:
  
  Our results support re-assessing and potentially lowering severity of this potential interaction in drug reference databases.
  
  
• Subjects:
  Aged Aged, 80 And Over Antineoplastic Combined Chemotherapy Protocols Article Breast Cancer Breast Neoplasms Chemotherapy Chemotherapy, Adjuvant Cyclophosphamide Drug Interactions Female Hospitalization Humans Hydrochlorothiazide Mastectomy Medicare Neutropenia SEER Program Treatment Outcome United States

  More +
• Source:
  Cancer Epidemiol Biomarkers Prev. 29(2):520-523
• Pubmed ID:
  31871107
• Pubmed Central ID:
  PMC7007357
• Document Type:
  Journal Article
• Funding:
  K12 CA120780/CA/NCI NIH HHS/United States ; UL1 TR001111/TR/NCATS NIH HHS/United States ; HHSN261201000140C/CA/NCI NIH HHS/United States ; HHSN261201000035C/CA/NCI NIH HHS/United States ; UL1 TR002489/TR/NCATS NIH HHS/United States ; HHSN261201000035I/CA/NCI NIH HHS/United States ; HHSN261201000034C/CA/NCI NIH HHS/United States ; U58 DP003862/DP/NCCDPHP CDC HHS/United States
• Volume:
  29
• Issue:
  2
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:0801625dd38f1ecd33d5b3eb7bdda85e3687263c2d11a28c9531dc51d2097142
• Download URL:
  https://stacks.cdc.gov/view/cdc/85008/cdc_85008_DS1.pdf
• File Type:
  [PDF - 60.78 KB ]