A New Drug-Drug Interaction Between Hydroxychloroquine and Metformin? A Signal Detection Study.
Identifieur interne : 001508 ( Main/Corpus ); précédent : 001507; suivant : 001509A New Drug-Drug Interaction Between Hydroxychloroquine and Metformin? A Signal Detection Study.
Auteurs : Jean-Louis Montastruc ; Pierre-Louis ToutainSource :
- Drug safety [ 1179-1942 ] ; 2020.
English descriptors
- KwdEn :
- Adult (MeSH), Adverse Drug Reaction Reporting Systems (statistics & numerical data), Betacoronavirus (isolation & purification), COVID-19 (MeSH), Coronavirus Infections (diagnosis), Coronavirus Infections (drug therapy), Coronavirus Infections (epidemiology), Drug Interactions (MeSH), Drug Therapy, Combination (adverse effects), Drug Therapy, Combination (mortality), Female (MeSH), Humans (MeSH), Hydroxychloroquine (pharmacokinetics), Hydroxychloroquine (therapeutic use), Hypoglycemic Agents (pharmacokinetics), Hypoglycemic Agents (therapeutic use), Male (MeSH), Metformin (pharmacokinetics), Metformin (therapeutic use), Middle Aged (MeSH), Pandemics (MeSH), Pharmacovigilance (MeSH), Pneumonia, Viral (diagnosis), Pneumonia, Viral (drug therapy), Pneumonia, Viral (epidemiology), SARS-CoV-2 (MeSH).
- MESH :
- chemical , pharmacokinetics : Hydroxychloroquine, Hypoglycemic Agents, Metformin.
- adverse effects : Drug Therapy, Combination.
- diagnosis : Coronavirus Infections, Pneumonia, Viral.
- drug therapy : Coronavirus Infections, Pneumonia, Viral.
- epidemiology : Coronavirus Infections, Pneumonia, Viral.
- isolation & purification : Betacoronavirus.
- mortality : Drug Therapy, Combination.
- statistics & numerical data : Adverse Drug Reaction Reporting Systems.
- chemical , therapeutic use : Hydroxychloroquine, Hypoglycemic Agents, Metformin.
- Adult, COVID-19, Drug Interactions, Female, Humans, Male, Middle Aged, Pandemics, Pharmacovigilance, SARS-CoV-2.
Abstract
INTRODUCTION
Hydroxychloroquine was recently promoted in patients infected with COVID-19 infection. A recent experimental study has suggested an increased toxicity of hydroxychloroquine in association with metformin in mice.
OBJECTIVE
The present study was undertaken to investigate the reality of this putative drug-drug interaction between hydroxychloroquine and metformin using pharmacovigilance data.
METHODS
Using VigiBase
RESULTS
Of the 10,771 Individual Case Safety Reports (ICSR) involving hydroxychloroquine, 52 were recorded as 'fatal outcomes'. In comparison with hydroxychloroquine alone, hydroxychloroquine + metformin was associated with an ROR value of 57.7 (23.9-139.3). In comparison with metformin alone, hydroxychloroquine + metformin was associated with an ROR value of 6.0 (2.6-13.8).
CONCLUSION
Our study identified a signal for the association hydroxychloroquine + metformin that appears to be more at risk of fatal outcomes (particularly by completed suicides) than one of the two drugs when given alone.
DOI: 10.1007/s40264-020-00955-y
PubMed: 32495148
PubMed Central: PMC7269161
Links to Exploration step
pubmed:32495148Le document en format XML
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A Signal Detection Study.</title><author><name sortKey="Montastruc, Jean Louis" sort="Montastruc, Jean Louis" uniqKey="Montastruc J" first="Jean-Louis" last="Montastruc">Jean-Louis Montastruc</name><affiliation><nlm:affiliation>Service de Pharmacologie Médicale et Clinique, Centre de PharmacoVigilance, de Pharmacoépidémiologie et d'Informations sur le Médicament, Faculté de Médecine, Centre Hospitalier Universitaire, 37 allées Jules-Guesde, 31000, Toulouse, France. jean-louis.montastruc@univ-tlse3.fr.</nlm:affiliation></affiliation></author><author><name sortKey="Toutain, Pierre Louis" sort="Toutain, Pierre Louis" uniqKey="Toutain P" first="Pierre-Louis" last="Toutain">Pierre-Louis Toutain</name><affiliation><nlm:affiliation>INTHERES, Université de Toulouse, INRA, ENVT, Toulouse, France.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>The Royal Veterinary College, University of London, London, UK.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2020">2020</date><idno type="RBID">pubmed:32495148</idno><idno type="pmid">32495148</idno><idno type="doi">10.1007/s40264-020-00955-y</idno><idno type="pmc">PMC7269161</idno><idno type="wicri:Area/Main/Corpus">001508</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">001508</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">A New Drug-Drug Interaction Between Hydroxychloroquine and Metformin? A Signal Detection Study.</title><author><name sortKey="Montastruc, Jean Louis" sort="Montastruc, Jean Louis" uniqKey="Montastruc J" first="Jean-Louis" last="Montastruc">Jean-Louis Montastruc</name><affiliation><nlm:affiliation>Service de Pharmacologie Médicale et Clinique, Centre de PharmacoVigilance, de Pharmacoépidémiologie et d'Informations sur le Médicament, Faculté de Médecine, Centre Hospitalier Universitaire, 37 allées Jules-Guesde, 31000, Toulouse, France. jean-louis.montastruc@univ-tlse3.fr.</nlm:affiliation></affiliation></author><author><name sortKey="Toutain, Pierre Louis" sort="Toutain, Pierre Louis" uniqKey="Toutain P" first="Pierre-Louis" last="Toutain">Pierre-Louis Toutain</name><affiliation><nlm:affiliation>INTHERES, Université de Toulouse, INRA, ENVT, Toulouse, France.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>The Royal Veterinary College, University of London, London, UK.</nlm:affiliation></affiliation></author></analytic><series><title level="j">Drug safety</title><idno type="eISSN">1179-1942</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult (MeSH)</term><term>Adverse Drug Reaction Reporting Systems (statistics & numerical data)</term><term>Betacoronavirus (isolation & purification)</term><term>COVID-19 (MeSH)</term><term>Coronavirus Infections (diagnosis)</term><term>Coronavirus Infections (drug therapy)</term><term>Coronavirus Infections (epidemiology)</term><term>Drug Interactions (MeSH)</term><term>Drug Therapy, Combination (adverse effects)</term><term>Drug Therapy, Combination (mortality)</term><term>Female (MeSH)</term><term>Humans (MeSH)</term><term>Hydroxychloroquine (pharmacokinetics)</term><term>Hydroxychloroquine (therapeutic use)</term><term>Hypoglycemic Agents (pharmacokinetics)</term><term>Hypoglycemic Agents (therapeutic use)</term><term>Male (MeSH)</term><term>Metformin (pharmacokinetics)</term><term>Metformin (therapeutic use)</term><term>Middle Aged (MeSH)</term><term>Pandemics (MeSH)</term><term>Pharmacovigilance (MeSH)</term><term>Pneumonia, Viral (diagnosis)</term><term>Pneumonia, Viral (drug therapy)</term><term>Pneumonia, Viral (epidemiology)</term><term>SARS-CoV-2 (MeSH)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="pharmacokinetics" xml:lang="en"><term>Hydroxychloroquine</term><term>Hypoglycemic Agents</term><term>Metformin</term></keywords><keywords scheme="MESH" qualifier="adverse effects" xml:lang="en"><term>Drug Therapy, Combination</term></keywords><keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="isolation & purification" xml:lang="en"><term>Betacoronavirus</term></keywords><keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>Drug Therapy, Combination</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Adverse Drug Reaction Reporting Systems</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Hydroxychloroquine</term><term>Hypoglycemic Agents</term><term>Metformin</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>COVID-19</term><term>Drug Interactions</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Pandemics</term><term>Pharmacovigilance</term><term>SARS-CoV-2</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>INTRODUCTION</b></p><p>Hydroxychloroquine was recently promoted in patients infected with COVID-19 infection. A recent experimental study has suggested an increased toxicity of hydroxychloroquine in association with metformin in mice.</p></div><div type="abstract" xml:lang="en"><p><b>OBJECTIVE</b></p><p>The present study was undertaken to investigate the reality of this putative drug-drug interaction between hydroxychloroquine and metformin using pharmacovigilance data.</p></div><div type="abstract" xml:lang="en"><p><b>METHODS</b></p><p>Using VigiBase</p></div><div type="abstract" xml:lang="en"><p><b>RESULTS</b></p><p>Of the 10,771 Individual Case Safety Reports (ICSR) involving hydroxychloroquine, 52 were recorded as 'fatal outcomes'. In comparison with hydroxychloroquine alone, hydroxychloroquine + metformin was associated with an ROR value of 57.7 (23.9-139.3). In comparison with metformin alone, hydroxychloroquine + metformin was associated with an ROR value of 6.0 (2.6-13.8).</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>Our study identified a signal for the association hydroxychloroquine + metformin that appears to be more at risk of fatal outcomes (particularly by completed suicides) than one of the two drugs when given alone.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">32495148</PMID><DateCompleted><Year>2020</Year><Month>07</Month><Day>02</Day></DateCompleted><DateRevised><Year>2021</Year><Month>01</Month><Day>10</Day></DateRevised><Article PubModel="Print"><Journal><ISSN IssnType="Electronic">1179-1942</ISSN><JournalIssue CitedMedium="Internet"><Volume>43</Volume><Issue>7</Issue><PubDate><Year>2020</Year><Month>07</Month></PubDate></JournalIssue><Title>Drug safety</Title><ISOAbbreviation>Drug Saf</ISOAbbreviation></Journal><ArticleTitle>A New Drug-Drug Interaction Between Hydroxychloroquine and Metformin? A Signal Detection Study.</ArticleTitle><Pagination><MedlinePgn>657-660</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1007/s40264-020-00955-y</ELocationID><Abstract><AbstractText Label="INTRODUCTION">Hydroxychloroquine was recently promoted in patients infected with COVID-19 infection. A recent experimental study has suggested an increased toxicity of hydroxychloroquine in association with metformin in mice.</AbstractText><AbstractText Label="OBJECTIVE">The present study was undertaken to investigate the reality of this putative drug-drug interaction between hydroxychloroquine and metformin using pharmacovigilance data.</AbstractText><AbstractText Label="METHODS">Using VigiBase<sup>®</sup>, the WHO pharmacovigilance database, we performed a disproportionality analysis (case/non-case study). Cases were reports of fatal outcomes with the drugs of interest and non-cases were all other reports for these drugs registered between 1 January 2000 and 31 December 2019. Data with hydroxychloroquine (or metformin) alone were compared with the association hydroxychloroquine + metformin. Results are reported as ROR (reporting odds ratio) with their 95% confidence interval.</AbstractText><AbstractText Label="RESULTS">Of the 10,771 Individual Case Safety Reports (ICSR) involving hydroxychloroquine, 52 were recorded as 'fatal outcomes'. In comparison with hydroxychloroquine alone, hydroxychloroquine + metformin was associated with an ROR value of 57.7 (23.9-139.3). In comparison with metformin alone, hydroxychloroquine + metformin was associated with an ROR value of 6.0 (2.6-13.8).</AbstractText><AbstractText Label="CONCLUSION">Our study identified a signal for the association hydroxychloroquine + metformin that appears to be more at risk of fatal outcomes (particularly by completed suicides) than one of the two drugs when given alone.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Montastruc</LastName><ForeName>Jean-Louis</ForeName><Initials>JL</Initials><Identifier Source="ORCID">0000-0001-6341-6001</Identifier><AffiliationInfo><Affiliation>Service de Pharmacologie Médicale et Clinique, Centre de PharmacoVigilance, de Pharmacoépidémiologie et d'Informations sur le Médicament, Faculté de Médecine, Centre Hospitalier Universitaire, 37 allées Jules-Guesde, 31000, Toulouse, France. jean-louis.montastruc@univ-tlse3.fr.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Toutain</LastName><ForeName>Pierre-Louis</ForeName><Initials>PL</Initials><AffiliationInfo><Affiliation>INTHERES, Université de Toulouse, INRA, ENVT, Toulouse, France.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>The Royal Veterinary College, University of London, London, UK.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList></Article><MedlineJournalInfo><Country>New Zealand</Country><MedlineTA>Drug Saf</MedlineTA><NlmUniqueID>9002928</NlmUniqueID><ISSNLinking>0114-5916</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D007004">Hypoglycemic Agents</NameOfSubstance></Chemical><Chemical><RegistryNumber>4QWG6N8QKH</RegistryNumber><NameOfSubstance 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