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Bordet C, Zureik M, Zelmat Y, Lafaurie M, Lapeyre-Mestre M, Sommet A, Mazieres J, Despas F. Deleterious association between proton pump inhibitor and protein kinase inhibitor exposure and survival for patients with lung cancer: A nationwide cohort study. Cancer Treat Res Commun 2024; 39:100801. [PMID: 38447474 DOI: 10.1016/j.ctarc.2024.100801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Revised: 02/01/2024] [Accepted: 02/22/2024] [Indexed: 03/08/2024]
Abstract
INTRODUCTION Previous studies have identified an interaction between protein kinase inhibitors (PKIs) and proton pump inhibitors (PPIs) in patients with lung cancer. This type of interaction may reduce the efficacy of PKIs. However, the effect of PKI-PPI interaction on patient mortality remains controversial. This study set out to determine the impact of PKI-PPI interaction on overall survival for lung cancer patients. MATERIALS AND METHODS This study was conducted using data from the French National Health Care Database from January 1, 2011 to December 31, 2021. We identified patients with: (i) an age equal to or greater than 18 years; (ii) lung cancer; and (iii) at least one reimbursement for one of the following drugs: erlotinib, gefitinib, afatinib and osimertinib. Patients were followed-up between the first date of PKI reimbursement and either December 31, 2021 or if they died, the date on which death occurred. The cumulative exposure to PPI duration during PKI treatment was calculated as the ratio between the number of concomitant exposure days to PKI and PPI and the number of exposure days to PKI. A survival analysis using a Cox proportional hazards model was then performed to assess the risk of death following exposure to a PKI-PPI interaction. RESULTS 34,048 patients received at least one reimbursement for PKIs of interest in our study: 26,133 (76.8 %) were exposed to erlotinib; 3,142 (9.2 %) to gefitinib; 1,417 (4.2 %) to afatinib; and 3,356 (9.9 %) to osimertinib. Patients with concomitant exposure to PKI-PPI interaction during 20 % or more of the PKI treatment period demonstrated an increased risk of death (HR, 1.60 [95 % CI, 1.57-1.64]) compared to other patients. When this cut-off varied from 10 % to 80 %, the estimated HR ranged from 1.46 [95 % CI, 1.43-1.50] to 2.19 [95 % CI, 2.12-2.25]. DISCUSSION/CONCLUSION In our study, an elevated risk of death was observed in patients exposed to PKI-PPI interaction. Finally, we were able to identify a dose-dependent effect for this interaction. This deleterious effect of osimertinib and PPI was revealed for the first time in real life conditions.
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Affiliation(s)
- Constance Bordet
- Medical and Clinical Pharmacology Department, Faculty of Medicine, Pharmacovigilance, Pharmacoepidemiology and Drug Information Center, CIC INSERM 1436, Faculty of Medicine, University Hospital Center, 31000, Toulouse, France
| | - Mahmoud Zureik
- EPI-PHARE, French National Agency for Medicines and Health Products Safety, French National Health Insurance, Saint-Denis, France
| | - Yoann Zelmat
- Medical and Clinical Pharmacology Department, Faculty of Medicine, Pharmacovigilance, Pharmacoepidemiology and Drug Information Center, CIC INSERM 1436, Faculty of Medicine, University Hospital Center, 31000, Toulouse, France
| | - Margaux Lafaurie
- Medical and Clinical Pharmacology Department, Faculty of Medicine, Pharmacovigilance, Pharmacoepidemiology and Drug Information Center, CIC INSERM 1436, Faculty of Medicine, University Hospital Center, 31000, Toulouse, France; University of Toulouse III-Paul Sabatier, 31062, Toulouse, France
| | - Maryse Lapeyre-Mestre
- Medical and Clinical Pharmacology Department, Faculty of Medicine, Pharmacovigilance, Pharmacoepidemiology and Drug Information Center, CIC INSERM 1436, Faculty of Medicine, University Hospital Center, 31000, Toulouse, France; University of Toulouse III-Paul Sabatier, 31062, Toulouse, France
| | - Agnès Sommet
- Medical and Clinical Pharmacology Department, Faculty of Medicine, Pharmacovigilance, Pharmacoepidemiology and Drug Information Center, CIC INSERM 1436, Faculty of Medicine, University Hospital Center, 31000, Toulouse, France; University of Toulouse III-Paul Sabatier, 31062, Toulouse, France
| | - Julien Mazieres
- University of Toulouse III-Paul Sabatier, 31062, Toulouse, France; Pneumology Department, Larrey Hospital, University Hospital Center, 31059, Toulouse, France; Toulouse Cancer Research Center (CRCT), French National Health and Medical Research Institute, French National Scientific Research Center (CNRS), 31100, Toulouse, France
| | - Fabien Despas
- Medical and Clinical Pharmacology Department, Faculty of Medicine, Pharmacovigilance, Pharmacoepidemiology and Drug Information Center, CIC INSERM 1436, Faculty of Medicine, University Hospital Center, 31000, Toulouse, France; University of Toulouse III-Paul Sabatier, 31062, Toulouse, France; Metabolic and Cardiovascular Diseases Institute, French National Health and Medical Research Institute (INSERM), UMR-1048, Toulouse, France.
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Casarotto E, Noize P, Gouverneur A, Berdaï D, Bégaud B, Levy‐Bachelot L, Molimard M. Overview of French databases available for studying anticancer drugs in real‐life setting. Fundam Clin Pharmacol 2020; 35:76-85. [DOI: 10.1111/fcp.12592] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 06/15/2020] [Accepted: 07/27/2020] [Indexed: 12/19/2022]
Affiliation(s)
- Emilie Casarotto
- Univ. Bordeaux, INSERM, BPH, U1219 Bordeaux F‐33000 France
- MSD France Puteaux F‐92800 France
| | - Pernelle Noize
- Univ. Bordeaux, INSERM, BPH, U1219 Bordeaux F‐33000 France
- Service de Pharmacologie médicale Pôle de Santé Publique CHU de Bordeaux Bordeaux F‐33000 France
| | - Amandine Gouverneur
- Univ. Bordeaux, INSERM, BPH, U1219 Bordeaux F‐33000 France
- Service de Pharmacologie médicale Pôle de Santé Publique CHU de Bordeaux Bordeaux F‐33000 France
| | - Driss Berdaï
- Service de Pharmacologie médicale Pôle de Santé Publique CHU de Bordeaux Bordeaux F‐33000 France
| | - Bernard Bégaud
- Univ. Bordeaux, INSERM, BPH, U1219 Bordeaux F‐33000 France
| | | | - Mathieu Molimard
- Univ. Bordeaux, INSERM, BPH, U1219 Bordeaux F‐33000 France
- Service de Pharmacologie médicale Pôle de Santé Publique CHU de Bordeaux Bordeaux F‐33000 France
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Gauthier M, Conte C, Palmaro A, Patras De Campaigno E, De Barros S, Huguet F, Laurent G, Lapeyre‐Mestre M, Despas F. Psychotropic drug initiation in patients diagnosed with chronic myeloid leukemia: a population‐based study in France. Fundam Clin Pharmacol 2020; 34:612-622. [DOI: 10.1111/fcp.12544] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Revised: 12/13/2019] [Accepted: 02/06/2020] [Indexed: 12/25/2022]
Affiliation(s)
- Martin Gauthier
- Département d’Hématologie Institut Universitaire du Cancer‐Oncopole 1 Avenue Irène Joliot‐Curie 31059 Toulouse Cedex France
| | - Cécile Conte
- Service de Pharmacologie Médicale et Clinique CHU de Toulouse 37 allées Jules Guesde 31000 Toulouse France
- UMR1027 Inserm Université Paul Sabatier Toulouse France
- Service de Pharmacologie Médicale et Clinique Faculté de Médecine Université Paul Sabatier Toulouse France
| | - Aurore Palmaro
- Service de Pharmacologie Médicale et Clinique CHU de Toulouse 37 allées Jules Guesde 31000 Toulouse France
- UMR1027 Inserm Université Paul Sabatier Toulouse France
- Service de Pharmacologie Médicale et Clinique Faculté de Médecine Université Paul Sabatier Toulouse France
- INSERM CIC 1436 Toulouse Centre d’Investigation Clinique de Toulouse Centre Hospitalier Universitaire de Toulouse France
| | - Emilie Patras De Campaigno
- Service de Pharmacologie Médicale et Clinique CHU de Toulouse 37 allées Jules Guesde 31000 Toulouse France
- UMR1027 Inserm Université Paul Sabatier Toulouse France
- Service de Pharmacologie Médicale et Clinique Faculté de Médecine Université Paul Sabatier Toulouse France
| | - Sandra De Barros
- Service de Pharmacologie Médicale et Clinique CHU de Toulouse 37 allées Jules Guesde 31000 Toulouse France
- Service de Pharmacologie Médicale et Clinique Faculté de Médecine Université Paul Sabatier Toulouse France
| | - Françoise Huguet
- Département d’Hématologie Institut Universitaire du Cancer‐Oncopole 1 Avenue Irène Joliot‐Curie 31059 Toulouse Cedex France
| | - Guy Laurent
- Département d’Hématologie Institut Universitaire du Cancer‐Oncopole 1 Avenue Irène Joliot‐Curie 31059 Toulouse Cedex France
- UMR1027 Inserm Université Paul Sabatier Toulouse France
| | - Maryse Lapeyre‐Mestre
- Service de Pharmacologie Médicale et Clinique CHU de Toulouse 37 allées Jules Guesde 31000 Toulouse France
- UMR1027 Inserm Université Paul Sabatier Toulouse France
- Service de Pharmacologie Médicale et Clinique Faculté de Médecine Université Paul Sabatier Toulouse France
- INSERM CIC 1436 Toulouse Centre d’Investigation Clinique de Toulouse Centre Hospitalier Universitaire de Toulouse France
| | - Fabien Despas
- Service de Pharmacologie Médicale et Clinique CHU de Toulouse 37 allées Jules Guesde 31000 Toulouse France
- UMR1027 Inserm Université Paul Sabatier Toulouse France
- Service de Pharmacologie Médicale et Clinique Faculté de Médecine Université Paul Sabatier Toulouse France
- INSERM CIC 1436 Toulouse Centre d’Investigation Clinique de Toulouse Centre Hospitalier Universitaire de Toulouse France
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