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Multicenter point prevalence evaluation of the utilization and safety of drug therapies for COVID-19 at the onset of the pandemic timeline in the United States.
- Source :
-
American Journal of Health-System Pharmacy . Apr2021, Vol. 78 Issue 7, p568-577. 10p. 1 Diagram, 3 Charts. - Publication Year :
- 2021
-
Abstract
- Key points In a multicenter point-prevalence study, we found that the rate of supportive care was high; among those receiving COVID-19 drug therapies, adverse reactions occurred in 12% of patients. Purpose There are currently no FDA-approved medications for the treatment of coronavirus disease 2019 (COVID-19). At the onset of the pandemic, off-label medication use was supported by limited or no clinical data. We sought to characterize experimental COVID-19 therapies and identify safety signals during this period. Methods We conducted a noninterventional, multicenter, point prevalence study of patients hospitalized with suspected/confirmed COVID-19. Clinical and treatment characteristics within a 24-hour window were evaluated in a random sample of up to 30 patients per site. The primary objective was to describe COVID-19–targeted therapies. The secondary objective was to describe adverse drug reactions (ADRs). Results A total of 352 patients treated for COVID-19 at 15 US hospitals From April 18 to May 8, 2020, were included in the study. Most patients were treated at academic medical centers (53.4%) or community hospitals (42.6%). Sixty-seven patients (19%) were receiving drug therapy in addition to supportive care. Drug therapies used included hydroxychloroquine (69%), remdesivir (10%), and interleukin-6 antagonists (9%). Five patients (7.5%) were receiving combination therapy. The rate of use of COVID-19–directed drug therapy was higher in patients with vs patients without a history of asthma (14.9% vs 7%, P = 0.037) and in patients enrolled in clinical trials (26.9% vs 3.2%, P < 0.001). Among those receiving drug therapy, 8 patients (12%) experienced an ADR, and ADRs were recognized at a higher rate in patients enrolled in clinical trials (62.5% vs 22%; odds ratio, 5.9; P = 0.028). Conclusion While we observed high rates of supportive care for patients with COVID-19, we also found that ADRs were common among patients receiving drug therapy, including those enrolled in clinical trials. Comprehensive systems are needed to identify and mitigate ADRs associated with experimental COVID-19 treatments. [ABSTRACT FROM AUTHOR]
- Subjects :
- *PREVENTION of drug side effects
*RESEARCH
*HOSPITALS
*INTERLEUKINS
*COVID-19
*COMBINATION drug therapy
*SCIENTIFIC observation
*ACADEMIC medical centers
*ASTHMA
*HUMAN research subjects
*CROSS-sectional method
*TOCILIZUMAB
*ANTIVIRAL agents
*MEDICAL cooperation
*DESCRIPTIVE statistics
*HYDROXYCHLOROQUINE
*STATISTICAL sampling
*ODDS ratio
*COVID-19 pandemic
*CHEMICAL inhibitors
Subjects
Details
- Language :
- English
- ISSN :
- 10792082
- Volume :
- 78
- Issue :
- 7
- Database :
- Academic Search Index
- Journal :
- American Journal of Health-System Pharmacy
- Publication Type :
- Academic Journal
- Accession number :
- 149401385
- Full Text :
- https://doi.org/10.1093/ajhp/zxaa426