|Year : 2022 | Volume
| Issue : 3 | Page : 102-104
The 2nd International Annual Conference of the SSCP Accepted Abstract: Pharmacotherapy; Students Theme
|Date of Web Publication||30-Sep-2022|
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
. The 2nd International Annual Conference of the SSCP Accepted Abstract: Pharmacotherapy; Students Theme. Saudi J Clin Pharm 2022;1:102-4
|How to cite this URL:|
. The 2nd International Annual Conference of the SSCP Accepted Abstract: Pharmacotherapy; Students Theme. Saudi J Clin Pharm [serial online] 2022 [cited 2023 Apr 1];1:102-4. Available from: http://www.sjcp.org/text.asp?2022/1/3/102/357713
| Theme 4: Pharmacotherapy; Students|| |
Evaluation of Hospital Compliance with Secondary Prevention in Discharged Stroke Patients: A Retrospective Chart Review Study
Maha Almutairi, Malak Alasqah, Shihanah Alharthi, Alaa Alhubaishi, Abdulhadi Alqahtani
Background: A stroke is a leading cause of disability and death worldwide. Globally, stroke affects 13.7 million individuals each year. Several studies have shown an increase in the rehospitalization rate among stroke patients caused by not adhering to American Heart Association/American Stroke Association (AHA/ASA) guideline recommendations for secondary stroke prevention.
Objective: The purpose of this study is to evaluate hospital compliance with the stroke secondary prevention AHA/ASA guideline upon discharge and the impact on the hospitalization rate.
Methods: This is a retrospective chart review study, conducted at King Fahad Medical City. The primary outcome of this study is the number of patients discharged with recommended medications according to the updated AHA/ASA guideline, whereas the secondary outcome of this study is measuring the history rate of hospitalization due to recurrent stroke. The data were obtained from the patients’ medical record files and analyzed by Statistical Package for the Social Sciences (SPSS).
Results: Of the 675 patients who were screened for eligibility, 507 were included and 168 were excluded. The mean ± SD age of patients was 59.5 ± 15.6 years. Of the 507 patients, only 382 (75.3%) discharged with the guideline recommendation. The history rate of hospitalization among stroke patients due to recurrent stroke was 35.4%.
Conclusion: Compliance with AHA/ASA guideline for secondary stroke prevention was high in this study, but not optimal for stroke patients. About one-third of stroke patients had a history of recurrent stroke.
The Impact of Rifampin Initiation on Systolic Blood Pressure in Patients Receiving Nifedipine: A Retrospective Study
Sana Alwafai, Khalid Eljaaly
Background: Nifedipine is still commonly used in Saudi Arabia, mainly for hypertension. Rifampin is a cytochrome P450 (CYP) 3A4 inducer, whereas nifedipine is metabolized by this CYP. Although there are pharmacokinetic data supporting this drug–drug interaction, the clinical data to date are lacking. This study aimed to investigate the changes in the systolic blood pressure (SBP) of hypertensive patients who were started on rifampin while they were receiving nifedipine.
Methods: This retrospective study was conducted at a tertiary care hospital in Jeddah, Saudi Arabia. We included hospitalized adults ≥18 years who were started on rifampin while they were receiving nifedipine for hypertension. Patients with uncontrolled hypertension (baseline SBP >140 mmHg) were excluded. The study outcomes were SBP changes by day 8 after rifampin initiation. Categorical data were analyzed using the χ2 test and Fisher’s exact test. Continuous data were analyzed using paired t-test for normally distributed data and Wilcoxon signed-rank test for non-normally distributed data.
Results: A total of 16 patients were included. The median age and body weight of the included patients were 63.5 (61.25–69.75) years and 73.1 (62–80) kg, respectively. Seven patients (43.8%) were male. The median baseline SBP reading was 133 (125.25–139) mmHg. The median increase in SBP was not significant on the second day but it achieved statistical significance on all the following days. The median maximum increase in SBP from baseline after the introduction of rifampin was 24 [17.75–29] mmHg.
Conclusion: Starting rifampin in hypertensive patients on nifedipine was associated with statistically and clinically significant increases in SBP. Patients using rifampin should temporarily substitute nifedipine with another class of antihypertensive medications.
Clinical and Therapeutic Characteristics of Patients with COVID-19 in Taif, Saudi Arabia
Raghad Alghamdi, Shumukh Althubaiti, Ghada Alosaimi, Najla Moaid Alharthi, Kholoud Althobaiti, Mawddah Qunq
Background: Coronavirus disease 2019 is a spreadable infectious disease caused by Coronaviridae family in the Nidovirales order. Corona represents crown-like spikes on the outer surface of the virus. Thus, it was named as coronavirus. At this time, there is vaccine for SARS-CoV-2 infection but there is no specific antiviral therapy. Some therapeutic medications are used such as antiviral, antimalaria, azithromycin, corticosteroids, and immunoglobulin. This study aims to describe the clinical features and therapeutics that were used in the management of COVID-19.
Methods: This will be a retrospective two-center case series study diagnosed with COVID-19. We extracted data from patients who were admitted to King Fasil Hospital and King Abdelaziz Specialty Hospital with a polymerase chain reaction confirming SARS-CoV-2 between March 12 and June 30, 2020.
Results: A total of 843 patients were hospitalized for COVID-19 during the study period. The mean age was 34.9 years (SD: 15.9 years). The most common comorbidity was diabetes mellitus (12.8%). Regarding the severity of the hospitalized patients, 517 patients (61.3%) were asymptomatic, 221 (26.2%) were mild, and 105 patients (12.5%) were severe or required intensive care unit. Four main types of therapies were prescribed to the patients for the management of COVID-19, including: antiviral therapy, antibiotics, antimalarial, and corticosteroid medications. Nearly half of the patients were on antibiotics (49.6%).
Conclusion: Many aspects of treatment remain unclear. Management of COVID-19 will require clinical investigation and intervention.
Comparative Effectiveness of Apixaban and Rivaroxaban Lead-in Dosing in Venous Thrombo-embolism Treatment: An Observational Multicenter Real-world Study
Fai Alnashmi, Omar Alshaya, Ghazwa Korayem, Majed Al Yami, Asma Gudayer, Sara Althewaibi, Lolwa Fetyani, Shaden Alshehri, Maram Albasseet, Lina Alshehri, Omar Almohammed
Background: Apixaban and rivaroxaban require lead-in dosing for 7 and 21 days, respectively, when treating patients with venous thrombo-embolism (VTE). However, no consensus currently exists regarding the appropriateness of subtracting parenteral anticoagulation days from total lead-in therapy duration. Thus, this study was conducted to assess the impact of two lead-in dosing regimens on VTE treatment.
Methods: Adult patients (≥ 18 years) with acute VTE who received apixaban or rivaroxaban and were not on prior therapeutic anticoagulants were included in a multicenter retrospective cohort study. Patients who received other anticoagulants were excluded. The incidence of recurrent VTE and major bleeding (MB) within 90 days were the main outcomes in the study.
Results: A total of 368 patients were included: 47.8% received apixaban and 52.2% received rivaroxaban. The recommended lead-in was used in 296 patients (80.4%), whereas 72 (19.6%) received the mixed lead-in regimen. Five patients had recurrent VTE events within 90 days; two occurred during hospitalization in the recommended group vs. none in the mixed group (0.7% vs. 0.0%; P=1.000). After discharge, two events occurred in the recommended group and one in the mixed group (0.7% vs. 1.4%; P=0.481). In terms of MB, 24 events occurred in 21 patients within 90 days. During hospitalization, 11 events occurred in the recommended group and seven in the mixed group (3.7% vs. 9.7%; P=0.060). After discharge, five more events occurred in the recommended group and one in the mixed group (1.4% vs. 1.7%; P=1.000).
Conclusion: The mixed lead-in regimen is comparable in terms of safety and effectiveness with the recommended lead-in regimen. However, large and robust studies are needed to confirm these results.
Real-world Assessment of Efficacy and Safety Parameters of Natalizumab Vs. Fingolimod in Patients with Relapsing–Remitting Multiple Sclerosis: A Systematic Review and Meta-Analysis
Mohammed Alzaid, Anas Alshamasneh, Saad Alajlan, Abdulrahaman Bakarman, Ahmed Abualawar
Background: The efficacy and safety of natalizumab compared with fingolimod for relapsing–remitting multiple sclerosis have given conflicting results, according to data from various medical centers around the world. As a result, we performed a systematic review and meta-analysis of data from real world evidence (RWE) studies to assess the effectiveness and safety of natalizumab vs. fingolimod.
Methods: MEDLINE and EMBASE were researched in the RWE studies, which were conducted to evaluate the efficacy and safety of natalizumab vs. fingolimod until April 2022. Review Manager 5.3 software was used to assess the data. The risk ratio (RR) and mean difference (MD) were analyzed and computed using a random-effects model.
Results: Pooled data from 14 studies, including 5380 patients, have demonstrated a similarity in the number of patients free of relapse between NTZ and FGL [RR 1.08, 95% confidence interval (CI) 0.97–1.20, P = 0.17]. Additionally, there was no significant difference between both the groups, with the pooled MD of 0.06 (95% CI −0.16 to −0.28, P = 0.60). Compared with the FGL group, the MRI results showed that the NTZ group could have a lower risk of increased gadolinium-enhanced lesions in T1 (RR 0.52, 95% CI 0.24–1.14, P=0.15). Serious adverse events assessed the safety outcomes. We combined the data collected from the eight observational studies and found that NTZ showed an insignificantly lower risk of adverse events (RR −0.04, 95% CI −0.13 to 0.04, P = 0.31).
Conclusion: In a real-world setting, NTZ has demonstrated no significant clinical advantage over FGL. Moreover, there is no significant difference in the RR for safety results.
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