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Association between concomitant use of hydrochlorothiazide and adverse chemotherapy-related events among older women with breast cancer treated with cyclophosphamide
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December 23 2019
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Source: Cancer Epidemiol Biomarkers Prev. 29(2):520-523
[PDF-60.78 KB]
Details:
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Alternative Title:Cancer Epidemiol Biomarkers Prev
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Personal Author:
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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.
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Source:
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Pubmed ID:31871107
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Pubmed Central ID:PMC7007357
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Document Type:
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Funding:
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Volume:29
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Issue:2
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