Journal Article

Time until onset of acute kidney injury by combination therapy with “Triple Whammy” drugs obtained from Japanese Adverse Drug Event Report database

Hira, Daiki, Kunitsu, Yuki, Morita, Shin-ya, Terada, Tomohiro, Isono, Tetsuichiro, Ueda, Tomohiro, Morikochi, Aya

2022

Overview

Acute kidney injury (AKI) associated with “Triple Whammy” drug therapy consisting of renin-angiotensin system inhibitors, diuretics, and nonsteroidal anti-inflammatory drugs (NSAIDs) has been reported. There have been no reports investigating “Triple Whammy” drug therapy and the time to AKI onset using adverse drug events report databases. The aim of this study was to determine the relationship between the time to AKI onset and treatment with “Triple Whammy” drug therapy. We analyzed AKI cases registered in the Japanese Adverse Drug Event Report database. The data were analyzed using the Kaplan–Meier approach, generalized Wilcoxon tests, and Weibull distribution. AKI was reported in 18,415 cases, of which 7,466 cases used Triple Whammy drugs. All combinations of Triple Whammy drugs were associated with significantly higher odds ratios for reporting AKI. In Weibull analysis, AKI onset was early for most combination patterns of Triple Whammy drugs. The Kaplan–Meier approach showed that the treatment duration to AKI onset was much shorter in cases using NSAIDs; median onsets, 8 days for triple combination, 7 days for NSAIDs added to renin-angiotensin system inhibitors, 9 days for NSAIDs added to diuretics, 6 days for diuretics added to NSAIDs, and 9 days for NSAIDs alone. AKI associated with Triple Whammy drugs is likely to occur in the early stages of treatment, especially with concomitant NSAIDs. Patients should be monitored for the occurrence of AKI within the first 2 weeks.

• Publisher: Public Library of Science,Public Library of Science (PLoS)
• Subject: Acute Kidney Injury - chemically induced / Acute Kidney Injury - epidemiology / Acute renal failure / Adverse Drug Reaction Reporting Systems - organization & administration / Adverse Drug Reaction Reporting Systems - statistics & numerical data / Aged / Aged, 80 and over / Angiotensin / Angiotensin Receptor Antagonists - administration & dosage / Angiotensin Receptor Antagonists - adverse effects / Angiotensin-Converting Enzyme Inhibitors - administration & dosage / Angiotensin-Converting Enzyme Inhibitors - adverse effects / Anti-inflammatory agents / Anti-Inflammatory Agents, Non-Steroidal - administration & dosage / Anti-Inflammatory Agents, Non-Steroidal - adverse effects / Antihypertensive Agents - administration & dosage / Antihypertensive Agents - adverse effects / Biology and Life Sciences / Care and treatment / Chemotherapy / Combination therapy / Complications and side effects / Databases, Factual - statistics & numerical data / Diuretics / Diuretics - administration & dosage / Diuretics - adverse effects / Drug therapy / Drug Therapy, Combination - adverse effects / Drug-Related Side Effects and Adverse Reactions - epidemiology / Female / Health risks / Humans / Incidence / Inflammation / Inhibitors / Japan - epidemiology / Kidneys / Male / Medicine and health sciences / Middle Aged / Nonsteroidal anti-inflammatory drugs / Patient outcomes / Pharmacy / Regression analysis / Renin / Time Factors / Weibull distribution