Prevalence of Potential Drug-Drug Interactions with Ritonavir-Containing Covid-19 Medications among the Adult Patient Population in Australia: Analysis of Pharmaceutical Benefits Scheme 10% Sample (Pbs10) Claims

Intro: Oral antiviral agents with differing modes of action are now available for the treatment of COVID-19. However, potentially life-threatening drug-drug interactions (DDIs) may occur if patients' underlying co-morbidities are treated with medications that are contraindicated with ritonavir-containing antivirals. This study evaluated the prevalence and severity of potential DDIs (pDDIs) with ritonavir-containing COVID-19 oral antiviral therapy among the Australian population. Method(s): Adult patients supplied with >=1 medication between January 1, 2019, and December 31, 2019, were identified in the PBS10 dataset, a longitudinal, random 10% sample of the national Pharmaceutical Benefits Scheme (PBS) data for supplied prescriptions. Patients receiving medications that have pDDIs with a ritonavir-containing COVID-19 antiviral treatment were classified as the pDDI group, using data sources from University of Liverpool, Lexicomp, or the US Food and Drugs Administration. Finding(s): Over 1,434,000 patients in the PBS10 were supplied with >=1 medication during the study period. The majority (58.8%) had been prescribed at least one medication with pDDI with ritonavir-containing treatment. Among all patients with pDDIs, 43.3% of them were major or contraindicated, followed by moderate (15.1%), and minor pDDIs (1.9%). Patients with cancer had the highest prevalence of contraindicated or major pDDIs (79.5%), followed by dementia and/or Alzheimer's (77.2%), and diabetes (73.8%). Elderly patients (>=60 years old) also had a higher prevalence of contradicted or major pDDI (65.4%) than the general patient population. Conclusion(s): Our results demonstrated that one-third of the Australian adult population in the PBS10 dataset may be classified as contraindicated with ritonavir-containing COVID-19 therapies. The prevalence of pDDI is much higher in elderly patients and in patients with certain co-morbidities. Health care providers will need to evaluate patients carefully should they be eligible for COVID-19 oral antiviral treatments. Alternative therapies should be considered as patients may be precluded from being treated with ritonavir-containing therapies owing to pDDIs.Copyright © 2023

New Insights from Chemical Biology: Molecular Basis of Transmission, Diagnosis, and Therapy of SARS-CoV-2

Coronavirus disease 2019 (COVID-19) is caused by a novel strain of coronavirus, designated as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It has caused a global pandemic rapidly sweeping across all countries, bringing social and economic hardship to millions. Most countries have implemented early warning measures to detect, isolate, and treat patients infected with SARS-CoV-2. This minireview summarizes some of those steps, in particular, testing methods and drug development in the context of chemical biology, and discusses the molecular basis of COVID-19's virulent transmissibility.