International Journal of Clinical Pharmacy最新文献

{"title":"Exploring Australian pharmacists' experiences with the electronic National Residential Medication Chart: a qualitative descriptive study.","authors":"Jonathan Tan, Jasmine Tan, Leanna de Souza, Qianying Wang, Alexander Wong, Jarrod Mcmaugh, Kenneth Lee, Amy Page","doi":"10.1007/s11096-025-01894-3","DOIUrl":"https://doi.org/10.1007/s11096-025-01894-3","url":null,"abstract":"<p><strong>Background: </strong>In Australia, the electronic National Residential Medication Chart (eNRMC) aims to enhance medication safety, reduce administrative burden, and communication in aged care facilities. However, research on its implementation is limited, with minimal pharmacist involvement, despite their critical role in medication management. It is essential to address the underrepresentation to optimise their experience with the eNRMC.</p><p><strong>Aim: </strong>This study aimed to explore the experiences of pharmacists who have used the (eNRMC) while providing care to residential aged care facilities.</p><p><strong>Method: </strong>A qualitative descriptive study design was employed, with thematic analysis conducted using The Framework Method. Pharmacists with experience using the eNRMC were recruited through purposive and snowball sampling and were invited to participate in semi-structured individual interviews in August 2024. Interviews were audio-visually recorded, transcribed using clean verbatim and analysed with NVivo software. An inductive coding approach was used to generate themes.</p><p><strong>Results: </strong>Twelve participants across Australia with varying levels of experience consented and completed semi-structured interviews. Three main themes were identified: (1) Improvements in Medication Management, (2) Limitations of the eNRMC Software, and (3) the Facility's Transition to eNRMC Software. Pharmacists reported enhanced medication safety, workflow, and communication. However, eNRMC incompatibilities, restricted editing and increased workloads were challenges during implementation. Additionally inadequate training and resistance from general practitioners contributed to charting errors and medication incidents.</p><p><strong>Conclusion: </strong>Pharmacists from various roles described the eNRMC as beneficial for enhancing medication management, but software limitations and lack of support remain barriers that increased frustrations amongst users and impede adoption.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opinions of visually impaired adults on the care provided at community pharmacies: a qualitative interview study.","authors":"Ellen Roche Ryan, Harriet Bennett-Lenane","doi":"10.1007/s11096-025-01888-1","DOIUrl":"https://doi.org/10.1007/s11096-025-01888-1","url":null,"abstract":"<p><strong>Background: </strong>Adults who are Visually Impaired (VI) often experience challenges in taking medications and interacting with healthcare settings.</p><p><strong>Aim: </strong>The aims of this study were to (1) explore the opinions of VI adults regarding care provided at community pharmacies in Ireland and (2) identify patient recommendations for improved care.</p><p><strong>Method: </strong>Semi-structured interviews were conducted using a topic guide via telephone or videoconference with VI adults who visit community pharmacies in Ireland. Interviewees were recruited on a voluntary basis using a mix of purposive, convenience and snowball sampling. Interviews were recorded, transcribed and carried out until theoretical data saturation. The Braun and Clarke approach was used for thematic data analysis using NVivo software.</p><p><strong>Results: </strong>Four major themes emerged from eighteen interviews. These were staff awareness, medicines information accessibility, physical inaccessibility and positive supports. Interviewees identified how open communication and close professional relationships between staff and VI adults could be influential in overcoming a perceived lack of independence and privacy currently experienced. Need for staff awareness training, improved provision of medicines information, improved physical accessibility of pharmacy layouts and use of mobile application as assistive technologies were also recommended.</p><p><strong>Conclusion: </strong>This study provides the first qualitative exploration of care provided to VI adults by community pharmacies in Ireland. Based on personal experiences, interviewees recommended mostly minor adjustments to pharmacy practice to increase accessibility and help provide improved care for this cohort when visiting a pharmacy. This work represents a springboard for future research involving bespoke interventions and tailored guidance for pharmacy teams.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143624473","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Defining histamine H2 receptor antagonist response in critically ill patients with heart failure: a machine learning cluster analysis.","authors":"Li-Juan Yang, Fang Yu, Yu Chen, Xin Zhang, Sun-Jun Yin, Ping Wang, Meng-Han Jiang, Hai-Ying Yang, Jia-De Zhu, Ran Xu, Wen-Ke Cai, Gong-Hao He","doi":"10.1007/s11096-025-01892-5","DOIUrl":"10.1007/s11096-025-01892-5","url":null,"abstract":"<p><strong>Background: </strong>Recent studies showed histamine H2 receptor antagonists (H2RAs) exposure was associated with reduced mortality in heart failure (HF) patients. However, specific HF patients who are sensitive to H2RAs exposure or not are yet to be further defined.</p><p><strong>Aim: </strong>This study aimed to identify HF patient characteristics that may benefit from H2RAs exposure.</p><p><strong>Method: </strong>Neural network-based variational autoencoders and Gaussian Mixture Model (GMM) clustering methods were employed to classify the critically ill patients with HF exposed to H2RAs based on Medical Information Mart for Intensive Care III and IV databases. Binary logistic and multivariable Cox regression analysis based on propensity score matching (PSM) were employed to estimate the association between H2RAs exposure of each cluster and all-cause mortality of included patients.</p><p><strong>Results: </strong>A total of 9,585 H2RAs users among 23,855 included HF patients were identified into four clusters according to GMM clustering: cluster 1 (combined with acute kidney failure, septic shock, and pneumonia), cluster 2 (combined with atrial fibrillation), cluster 3 (combined with coronary artery disease (CAD) and/or had higher urine output), and cluster 4 (co-administered with calcium-antagonists). The cluster 3 patients were significantly associated with reduced all-cause mortality compared with non-H2RAs users after PSM, which were further validated in 14,280 HF patients from the large multi-center electronic intensive care unit Collaborative Research Database (eICU-CRD).</p><p><strong>Conclusion: </strong>Histamine H2 receptor antagonist exposure was more sensitive in HF patients who were combined with CAD. Furthermore, male HF patients or those with higher urine output were also sensitive to H2RAs exposure.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143582241","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating the controversy surrounding statin therapy and Achilles tendinopathy using Mendelian randomization analysis.","authors":"Jie Zhou, Haitao Wang, Chao Chen, Kun Wang, Yixin Xu","doi":"10.1007/s11096-025-01893-4","DOIUrl":"https://doi.org/10.1007/s11096-025-01893-4","url":null,"abstract":"<p><strong>Background: </strong>The relationship between statin therapy and tendon injuries, particularly Achilles tendinopathy, which is the body's largest and strongest tendon, remains controversial.</p><p><strong>Aim: </strong>This study employed Mendelian Randomization (MR) analysis to explore the causal link between statin therapy and Achilles tendinopathy (ATP).</p><p><strong>Method: </strong>Summary statistics were obtained from genome-wide association studies on statin medication and four specific statin drugs from public databases, as well as data related to two ATP phenotypes, namely Achilles tendinitis and Achilles tendon injury. Furthermore, a two-sample bidirectional MR analysis was conducted to investigate the association between statin therapy and ATP. The primary method used was the inverse variance weighted (IVW) method, supplemented by four other validation methods. Heterogeneity analysis, pleiotropy assessment, and leave-one-out sensitivity analysis were further conducted to validate the robustness of the results.</p><p><strong>Results: </strong>Based on our comprehensive investigation, all MR analyses in this study found no significant causal relationship between statin therapy and ATP (IVW, p > 0.05). Notably, the MR findings regarding pravastatin, rosuvastatin, and ATP were limited by a small pool of instrumental variables, necessitating further research. Moreover, no association was observed between the two in the reverse MR analysis (IVW, p > 0.05). All results passed heterogeneity tests, pleiotropy tests, and sensitivity analyses.</p><p><strong>Conclusion: </strong>Our results do not establish a causal connection between statin therapy and ATP, indicating that individuals with ATP should consider alternative pathogenic contributors. Moreover, these findings highlight the safety profile of statin medications.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143572953","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bacillus coagulans TBC169 probiotics for intestinal function recovery after gynecological open surgery: a randomized, double-blind, placebo-controlled trial.","authors":"Zhaobo Guan, Zhijiao Zhang, Pengyan Jia, Juan Xu, Niuniu Bai, Chunxia Hou, Weihong Chen, Weiqi Gao","doi":"10.1007/s11096-025-01881-8","DOIUrl":"https://doi.org/10.1007/s11096-025-01881-8","url":null,"abstract":"<p><strong>Background: </strong>Restoration of intestinal function after open surgery remains a significant challenge in gynecological practice. Bacillus coagulans TBC169 probiotics may enhance intestinal motility and recovery.</p><p><strong>Aim: </strong>This randomized controlled trial aimed to evaluate the efficacy and safety of Bacillus coagulans TBC169 in promoting intestinal function recovery after gynecological open abdominal surgery.</p><p><strong>Method: </strong>Patients undergoing open surgery were randomly assigned to high-dose (HDG), conventional-dose (CDG), or placebo-controlled (PCG) groups. The primary outcome was the time to first flatus (TFF). Secondary outcomes included time to first defecation (TFD), time to first bowel sounds (TFBS), duration of hospital stay (DHS), and postoperative complication rate (PCR).</p><p><strong>Results: </strong>A total of 114 patients were included, with 38 patients allocated to each group. TFF was significantly shorter in the CDG (25.8 h vs. 38.1 h, P < 0.001) and the HDG (23.1 h vs. 38.1 h, P < 0.001) than the PCG. TFBS was significantly reduced in the CDG (16.1 h vs. 19.3 h, P < 0.05) and the HDG (14.3 h vs. 19.3 h, P < 0.001). Patients in the HDG had a significantly shorter TFD than the PCG (61.2 h vs. 66.4 h, P < 0.05). However, DHS did not differ significantly among the groups. PCR was markedly lower in the CDG (34.2% vs. 68.4%, P < 0.01) and HDG (21.1% vs. 68.4%, P < 0.001) compared to the PCG. No adverse events were reported across the groups.</p><p><strong>Conclusion: </strong>Bacillus coagulans TBC169 accelerates intestinal function recovery and reduces postoperative complications following gynecologic open surgery.</p><p><strong>Trial registration: </strong>The study protocol was registered with the China Clinical Trials Registry (ChiCTR2200059518).</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient and hospital staff perspectives on introducing pharmacist-led medication reviews at an orthopedic ward: a mixed methods pilot study.","authors":"Joo Hanne Poulsen Revell, Maja Schlünsen, Abisha Kandasamy, Annette Meijers, Jens Eggers, Lene Juel Kjeldsen","doi":"10.1007/s11096-025-01874-7","DOIUrl":"https://doi.org/10.1007/s11096-025-01874-7","url":null,"abstract":"<p><strong>Background: </strong>Multi-morbidity is associated with multiple medication use, which potentially increases the risk of adverse drug events. Pharmacist-led medication reviews have been introduced to meet these challenges.</p><p><strong>Aim: </strong>To evaluate the implementation of pharmacist-led medication reviews for older patients admitted to an orthopedic ward in terms of quality and safety from the perspectives of patients, hospital-based physicians, nurses, and healthcare assistants.</p><p><strong>Method: </strong>Patients (n=11) were interviewed, with the interviews having a reflexive thematic analysis using the hermeneutic approach, while healthcare-professionals' (HCPs) (n=26) perspectives on pharmacist-led medication reviews were assessed using questionnaires.</p><p><strong>Results: </strong>The qualitative patient interviews revealed four themes: (1) Positive perception of pharmacists' medication communication, (2) Mixed perceptions of a medication review, (3) Satisfaction with the general outcome of the medication review, and (4) Safety perception with medication treatment. Twenty-six HCPs completed the questionnaire (response rate 48%) with a distribution of 10 hospital-based physicians (38%), eight nurses (31%), and eight healthcare assistants (31%). Almost 85% of the HCPs (n = 22) were familiar with the pharmacist conducting medication reviews. More than 70% of the HCPs reported that pharmacist-led medication reviews contributed to increased quality of admitted patients' medication use.</p><p><strong>Conclusion: </strong>High levels of satisfaction with the outcomes of the medication reviews-particularly regarding quality, patient safety, and their overall positive impact on the ward-indicate that both patients and HCPs perceived the service as highly valuable in supporting patient care throughout the medication process.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143457809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medication-induced causes of delirium in patients with and without dementia: a systematic review of published neurology guidelines.","authors":"Anita Elaine Weidmann, Guðný Björk Proppé, Rut Matthíasdóttir, Ivana Tadić, Pétur Sigurdur Gunnarsson, Freyja Jónsdóttir","doi":"10.1007/s11096-024-01861-4","DOIUrl":"https://doi.org/10.1007/s11096-024-01861-4","url":null,"abstract":"<p><strong>Background: </strong>While medication is a recognized risk factor of delirium, there is currently a lack of detailed information on managing and preventing medication-induced cases.</p><p><strong>Aim: </strong>This review summarizes the information provided in neurology guidelines on medication-induced delirium in patients with and without dementia to inform guidance on prevention and management strategies.</p><p><strong>Method: </strong>A systematic literature review was conducted across 114 neurological and medical organisations, Guideline Central and PubMed. Guidelines, consensus guidelines, white papers, frameworks, protocols, standard procedures, action plans and strategic documents detailing the prevention and management of medication-induced delirium in adults with or without dementia were included. Title and full-text screening was completed independently by two reviewers using PICOS. AGREE II was used to assess reporting quality. A data extraction tool was designed based on the Cochrane Effective Practice and Organization of Care Review Group (EPOC) checklist and a mixed methods approach to synthesis adopted. The systematic review protocol was registered with International Prospective Register of Systematic Reviews (PROSPERO) [ID: CRD42022366025].</p><p><strong>Results: </strong>Out of 143 guidelines identified, 30 were included. Information for 140 individual medications was extracted. Medications most frequently cited included sedatives (n = 24/80%), opioids (n = 22/73,3%), psychoactive drugs (n = 21/70%) + anti-convulsants (n = 14/46,7%), anti-cholinergic agents (n = 20/66,7%), antihistamines (n = 18/60%), and steroids (n = 16/53,3%). Despite a consistently high-quality rating (n = 19, 63,3%), the detail provided often lacks specificity about pharmacological mechanisms, individual risk, dosing instructions, associated symptoms, therapeutic alternatives and avoidable drug-drug combinations. In relation to dementia, detailed information on the use of antipsychotics, cholinesterase inhibitors and benzodiazepines was extracted. No papers were excluded based on their quality.</p><p><strong>Conclusion: </strong>No single guideline contains enough information on the risk, prevention, and management of medication-induced delirium to sufficiently support clinical decision making.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Defining polypharmacy in older adults: a cross-sectional comparison of prevalence estimates calculated according to active ingredient and unique product counts.","authors":"Georgie B Lee, Sarah M Hosking, Christopher Etherton-Beer, Julie A Pasco, Lana J Williams, Kara L Holloway-Kew, Amy T Page","doi":"10.1007/s11096-025-01882-7","DOIUrl":"https://doi.org/10.1007/s11096-025-01882-7","url":null,"abstract":"<p><strong>Background: </strong>Polypharmacy is common in older adults and may be associated with poor outcomes. However, methods used to define polypharmacy are rarely reported precisely, with potential implications for polypharmacy exposure estimates.</p><p><strong>Aim: </strong>The aim was to investigate prevalence estimates according to different methods in an Australian population-based sample of older adults.</p><p><strong>Method: </strong>This cross-sectional study included 735 adults aged ≥ 60 years participating in the Geelong Osteoporosis Study. Current prescription, non-prescription and complementary and alternative medicines were self-reported. Counting methods included the number of active ingredients and unique products. Polypharmacy and hyperpolypharmacy were determined using ≥ 5 and ≥ 10 medicine cut points respectively. Prevalence was estimated using ingredient- and product-level counts according to criteria defined by medicine schedule and type (i.e. scheduled prescription, non-prescription). Non-parametric testing measured differences between counting methods, univariate logistic regressions investigated disagreement between total counts and polypharmacy exposure.</p><p><strong>Results: </strong>Polypharmacy prevalence (scheduled prescription medicines) was 30.3% and 35.9% (products versus ingredients). Prevalence increased to 52.8% and 57.3% when counts considered any medicine. Adults aged ≥ 80 years were most likely to use prescription combination products (OR 2.22 [95% CI 1.46, 3.35] p < 0.01), however, age was not associated with disagreement between product and ingredient polypharmacy exposure. Being male was associated with both prescription combination product use (OR 1.79 [95% CI 1.29, 2.47] p < 0.001) and disagreement between polypharmacy exposures (OR 2.29 [95% CI 1.15, 4.47] p=0.02).</p><p><strong>Conclusion: </strong>Polypharmacy prevalence estimates varied substantially depending on the method applied. These data indicate the need for standardised reporting specific to medicines data and polypharmacy measures.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pharmacy-led interventions to reverse and prevent prescribing cascades in primary care: a proof-of-concept study.","authors":"Atiya K Mohammad, Jacqueline G Hugtenburg, Yildiz Ceylan, Marcel Kooij, Saskia Knies, Patricia M L A van den Bemt, Petra Denig, Fatma Karapinar-Carkıt","doi":"10.1007/s11096-025-01873-8","DOIUrl":"https://doi.org/10.1007/s11096-025-01873-8","url":null,"abstract":"<p><strong>Background: </strong>Prescribing cascades occur in clinical practice when a medication causes an adverse drug reaction (ADR), which is addressed by prescribing additional medication.</p><p><strong>Aim: </strong>The aim was to provide proof-of-concept for pharmacy-led interventions to reverse or prevent prescribing cascades.</p><p><strong>Method: </strong>Two community pharmacies each tested two approaches. To reverse prescribing cascades, ten cascades were selected from literature. Dispensing records were screened to identify patients with these cascades. To prevent prescribing cascades, patients who started medications associated with five of these cascades were telephoned one month after their first dispensing to discuss ADRs. Pharmacists assessed the need to intervene together with prescribers. Primary outcome was the proportion of patients with a treatment change initiated. Secondary outcomes were time investment, potential cost-savings, and pharmacists' experiences.</p><p><strong>Results: </strong>To reverse prescribing cascades, 24 patients were included. For eight the prescriber was consulted, resulting in the reversal of three cascades. Forty-four patients were included to prevent prescribing cascades. Six of them experienced an ADR that could lead to a prescribing cascade. For two patients interventions were conducted to prevent this. The estimated time investment to identify patients possibly in need of intervention was 4.5 h for the reversing approach and 4.8 h for the preventing approach, while follow-up actions required 1.8 h and 0.5 h, respectively. Both approaches could be cost-saving. Pharmacists considered both approaches relevant but identified a knowledge gap on how to intervene for some cascades.</p><p><strong>Conclusion: </strong>Pharmacy-led interventions may reverse and prevent prescribing cascades, but more efficient screening methods and tools are needed before further implementation.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic polymorphisms and anti-tuberculosis drug-induced liver injury: an umbrella review of the evidence.","authors":"Jingru Cheng, Jia Zhu, Ruina Chen, Meiling Zhang, Bing Han, Min Zhu, Yiwen He, Honggang Yi, Shaowen Tang","doi":"10.1007/s11096-025-01880-9","DOIUrl":"https://doi.org/10.1007/s11096-025-01880-9","url":null,"abstract":"<p><strong>Background: </strong>Anti-tuberculosis drug-induced liver injury (ATLI) is a significant adverse drug reaction with genetic susceptibility implications.</p><p><strong>Aim: </strong>This study aimed to integrate findings from systematic reviews and meta-analyses on genetic polymorphisms associated with ATLI risk, enhance evidence synthesis, and identify susceptibility gene polymorphisms linked to ATLI occurrence.</p><p><strong>Method: </strong>The protocol was registered in PROSPERO (CRD42024517311). Systematic searches of PubMed, EMBASE, Web of Science, and Cochrane Library databases were conducted to identify eligible studies from inception to February 21, 2024. Two authors independently reviewed eligibility, extracted data, and assessed quality. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to evaluate associations between genetic polymorphisms and ATLI susceptibility.</p><p><strong>Results: </strong>A total of 25 meta-analyses were included, including 57 single nucleotide polymorphisms (SNPs) in 15 candidate genes. Significant associations were found for the glutathione S-transferase M1 (GSTM1) null genotype (OR = 1.43, 95% CI: 1.18-1.73, P < 0.001) and N-acetyltransferase 2 (NAT2) polymorphisms, including rs1799929 (dominant model, OR = 1.35, 95% CI: 1.12-1.63, P < 0.001), rs1799930 (dominant model, OR = 1.43, 95% CI: 1.23-1.66, P < 0.001), rs1799931 (dominant model, OR = 1.22, 95% CI: 1.02-1.46, P = 0.03), and the slow acetylator (SA) phenotype (OR = 2.91, 95% CI: 2.43-3.49, P < 0.001). No significant association was found between the CYP2E1 RsaI/PstI polymorphism (C1/C1 genotype) and ATLI risk (dominant model, OR = 0.79, 95% CI: 0.61-1.02, P = 0.08).</p><p><strong>Conclusion: </strong>This umbrella review confirms that the GSTM1 null genotype, NAT2 polymorphisms (rs1799929, rs1799930, rs1799931), and the slow acetylator phenotype are associated with increased ATLI risk. These findings provide a foundation for further research on genotype-guided approaches to mitigating ATLI.</p>","PeriodicalId":13828,"journal":{"name":"International Journal of Clinical Pharmacy","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143425441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}