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

Details

• Journal Article:
  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:
  • Article
  • drug interactions
  • chemotherapy
  • breast cancer
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols
  • Breast Neoplasms
  • Chemotherapy, Adjuvant
  • Cyclophosphamide
  More +
• Source:
  Cancer Epidemiol Biomarkers Prev. 29(2):520-523
• DOI:
  http://dx.doi.org/10.1158/1055-9965.EPI-19-1079
• Pubmed ID:
  31871107
• Pubmed Central ID:
  PMC7007357
• Document Type:
  Text ; 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
• Genre:
  Journal Article
• Volume:
  29
• Issue:
  2
• Download URL:
  https://stacks.cdc.gov/view/cdc/85008/cdc_85008_DS1.pdf
• File Type:
  [PDF - 60.78 KB]
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:c3950b43afe72272f19443ae453b3acad3a633c7370a8fb6e90ec0a6301ae167c1b81822317bed56b795b15cbb7843f0c2573e2058b662ab0f30b1a91790e3ed