TY  - JOUR
PY  - 2024//
TI  - Are polypharmacy side effects predicted by public data still valid in real-world data?
JO  - Heliyon
A1  - Kee, Gaeun
A1  - Kang, Hee Jun
A1  - Ahn, Imjin
A1  - Gwon, Hansle
A1  - Kim, Yunha
A1  - Seo, Hyeram
A1  - Choi, Heejung
A1  - Cho, Ha Na
A1  - Kim, Minkyoung
A1  - Han, JiYe
A1  - Park, Seohyun
A1  - Kim, Kyuwoong
A1  - Jun, Tae Joon
A1  - Kim, Young-Hak
SP  - e24620
EP  - e24620
VL  - 10
IS  - 2
N2  - BACKGROUND AND OBJECTIVE: Although interest in predicting drug-drug interactions is growing, many predictions are not verified by real-world data. This study aimed to confirm whether predicted polypharmacy side effects using public data also occur in data from actual patients. <br><br>METHODS: We utilized a deep learning-based polypharmacy side effects prediction model to identify cefpodoxime-chlorpheniramine-lung edema combination with a high prediction score and a significant patient population. The retrospective study analyzed patients over 18 years old who were admitted to the Asan medical center between January 2000 and December 2020 and took cefpodoxime or chlorpheniramine orally. The three groups, cefpodoxime-treated, chlorpheniramine-treated, and cefpodoxime & chlorpheniramine-treated were compared using inverse probability of treatment weighting (IPTW) to balance them. Differences between the three groups were analyzed using the Kaplan-Meier method and Cox proportional hazards model. <br><br>RESULTS: The study population comprised 54,043 patients with a history of taking cefpodoxime, 203,897 patients with a history of taking chlorpheniramine, and 1,628 patients with a history of taking cefpodoxime and chlorpheniramine simultaneously. After adjustment, the 1-year cumulative incidence of lung edema in the patient group that took cefpodoxime and chlorpheniramine simultaneously was significantly higher than in the patient groups that took cefpodoxime or chlorpheniramine only (p=0.001). Patients taking cefpodoxime and chlorpheniramine together had an increased risk of lung edema compared to those taking cefpodoxime alone [hazard ratio (HR) 2.10, 95% CI 1.26-3.52, p<0.005] and those taking chlorpheniramine alone, which also increased the risk of lung edema (HR 1.64, 95% CI 0.99-2.69, p=0.05). <br><br>CONCLUSIONS: Validation of polypharmacy side effect predictions with real-world data can aid patient and clinician decision-making before conducting randomized controlled trials. Simultaneous use of cefpodoxime and chlorpheniramine was associated with a higher long-term risk of lung edema compared to the use of cefpodoxime or chlorpheniramine alone.<p />  <p>Language: en</p>
LA  - en
SN  - 2405-8440
UR  - http://dx.doi.org/10.1016/j.heliyon.2024.e24620
ID  - ref1
ER  -