J Sultana1, U M Musazzi2, Y Ingrasciotta1, F Giorgianni1, V Ientile1, A Fontana3, P Minghetti2, M Perrotta4, D Santoro1, V Savica1, G Trifirò5. 1. Department of Clinical and Experimental Medicine, University of Messina, Italy. 2. Department of Pharmaceutical Sciences, University of Milan, Italy. 3. Unit of Biostatistics, IRCCS "Casa Sollievo della Sofferenza", San Giovanni Rotondo, Foggia, Italy. 4. Caserta Local Health Service, Caserta, Italy. 5. Department of Clinical and Experimental Medicine, University of Messina, Italy. Electronic address: trifirog@unime.it.
Abstract
BACKGROUND AND AIMS: Hyperphosphatemia increases the risk of cardiovascular morbidity but the use of medicines as a source of phosphate has not been investigated yet. This study aims to explore the use of absorbable phosphate-containing drugs in CKD patients. METHODS AND RESULTS: Incident CKD patients were identified within the Arianna database (containing data from 158,510 persons in Caserta (Southern Italy) registered with 123 general practitioners) from 2005 to 2011. Drugs prescribed to these patients were classified as phosphate-containing based on the summary of product characteristics (SPC), PubChem and Micromedex. The number and duration of prescriptions for these drugs as well as the overall intake of phosphate were estimated. Out of 1989 CKD patients, 1381 (70%) were prescribed 266 medicinal products containing absorbable phosphate over a median follow-up of 6 years (interquartile range (IQR) = 5.2-6.0). Most patients were prescribed ATC A (650; 47.1%) and C (660; 47.8%) phosphate-containing drug products targeting the gastrointestinal and cardiovascular system for a median of 232 (IQR: 56-656) and 224 (IQR: 56-784) days respectively. CONCLUSIONS: Several medications, especially chronically prescribed ones, contain absorbable phosphate. This study's findings confirm the relevance of medicines as a phosphate source for the first time.
BACKGROUND AND AIMS: Hyperphosphatemia increases the risk of cardiovascular morbidity but the use of medicines as a source of phosphate has not been investigated yet. This study aims to explore the use of absorbable phosphate-containing drugs in CKDpatients. METHODS AND RESULTS: Incident CKDpatients were identified within the Arianna database (containing data from 158,510 persons in Caserta (Southern Italy) registered with 123 general practitioners) from 2005 to 2011. Drugs prescribed to these patients were classified as phosphate-containing based on the summary of product characteristics (SPC), PubChem and Micromedex. The number and duration of prescriptions for these drugs as well as the overall intake of phosphate were estimated. Out of 1989 CKDpatients, 1381 (70%) were prescribed 266 medicinal products containing absorbable phosphate over a median follow-up of 6 years (interquartile range (IQR) = 5.2-6.0). Most patients were prescribed ATC A (650; 47.1%) and C (660; 47.8%) phosphate-containing drug products targeting the gastrointestinal and cardiovascular system for a median of 232 (IQR: 56-656) and 224 (IQR: 56-784) days respectively. CONCLUSIONS: Several medications, especially chronically prescribed ones, contain absorbable phosphate. This study's findings confirm the relevance of medicines as a phosphate source for the first time.
Authors: Enrica Menditto; Valentina Orlando; Giuseppe De Rosa; Paola Minghetti; Umberto Maria Musazzi; Caitriona Cahir; Marta Kurczewska-Michalak; Przemysław Kardas; Elísio Costa; José Manuel Sousa Lobo; Isabel F Almeida Journal: Pharmaceutics Date: 2020-01-03 Impact factor: 6.321