Prevalence and nature of statin drug-drug interactions in a universityhospital by electronic health record mining

AbstractAim Our aim was to describe prevalence, nature, and level of severity of potential statin drug-drug interactions in a universityhospital.Methods In a cross-sectional study, statin drug-drug interactions were screened from medical record of 10,506 in-patients treatedstored in the clinical data warehouse BeHOP.^ We screened drug-drug interactions using Theriaque and Micromedex drugdatabases.Results A total of 22.5% of patients were exposed to at least one statin drug-drug interaction. Given their lipophilicity andCYP3A4 metabolic pathway, atorvastatin and simvastatin presented a higher prevalence of drug-drug interactions whilefluvastatin presented the lowest prevalence. Up to 1% of the patients was exposed to a contraindicated drug-drug interaction,the most frequent drug-drug interaction involving influx-transporter (i.e., OATP1B1) interactions between simvastatin orrosuvastatin with cyclosporin. The second most frequent contraindicated drug-drug interaction involved CYP3A4 interactionbetween atorvastatin or simvastatin with either posaconazole or erythromycin. Furthermore, our analysis showed some discrepanciesbetween Theriaque and Micromedex in the prevalence and the nature of drug-drug interactions.Conclusions Different drug-drug interaction profiles were observed between statins with a higher prevalence of CYP3A4-basedinteractions for lipophilic statins. Analyzing the three most frequent DDIs, the more significant DDIs (level 1: contraindication)were reported for transporter-based DDI involving OATP1B1 influx transporter. These points are of concern to improve prescriptionsof statins.Keywords Statins . Pharmacokinetics . Drug-drug interactions . Metabolic enzymes . Drug transporters . Drug databases .Data mining . Clinical data warehous