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- W2063485354 abstract "Background: Neutropenia is one of the most important dose-limiting toxicities of docetaxel, and often necessitates dose reduction from the initial dosage. Clarithromycin is a macrolide antibiotic used to treat chronic bronchus disease generally. Docetaxel is metabolized by cytochrome P450 3A4 (CYP3A4) enzymes in human liver, and clarithromycin is a potent inhibitor of CYP3A4. However, the drug interaction of docetaxel and clarithromycin for neutropenia is not well known.Methods: The aim of this study was to evaluate whether the risk of docetaxel-induced severe neutropenia was increased by concomitant administration of clarithromycin. Patients with non-small cell lung cancer (NSCLC) receiving tri-weekly docetaxel were identified from electronic medical record system of Shizuoka general hospital, and then divided into two groups: concomitant administration of clarithromycin group and non-concomitant group. The Proportions of patients experiencing grade 4 neutropenia between the two groups was compared by the chi-square test. Potential risk factors associated with grade 4 neutropenia were explored by the univariate and multivariate logistic regression analyses.Results: A total of 158 patients with NSCLC were analyzed. The incidence of grade 4 neutropenia was more frequently detected in patients with clarithromycin than without clarithromycin (63.2 vs. 35.3%; P = 0.025). The following risk factors were found in the univariate analysis and included into the multivariate analysis: pretreatment absolute neutrophil counts, pretreatment total bilirubin levels, co-administration of clarithromycin, female gender, and pretreatment albumin levels. The multivariate analysis showed that co-administration of clarithromycin (odds ratio [OR] 4.98; 95% confidence interval [CI] 1.66-14.96), female gender (OR 2.75; 95%CI 1.11-6.82), and pretreatment absolute neutrophil counts (OR 2.62; 95%CI 1.25-5.50) increased grade 4 neutropenia.Conclusions: The present study showed that concomitant administration of clarithromycin potentiated docetaxel-induced severe myelosuppression. This analysis suggests that patients with co-administration of clarithromycin, pretreatment absolute neutrophil counts and female gender might be risk factors for the incidence of grade 4 neutropenia. Background: Neutropenia is one of the most important dose-limiting toxicities of docetaxel, and often necessitates dose reduction from the initial dosage. Clarithromycin is a macrolide antibiotic used to treat chronic bronchus disease generally. Docetaxel is metabolized by cytochrome P450 3A4 (CYP3A4) enzymes in human liver, and clarithromycin is a potent inhibitor of CYP3A4. However, the drug interaction of docetaxel and clarithromycin for neutropenia is not well known. Methods: The aim of this study was to evaluate whether the risk of docetaxel-induced severe neutropenia was increased by concomitant administration of clarithromycin. Patients with non-small cell lung cancer (NSCLC) receiving tri-weekly docetaxel were identified from electronic medical record system of Shizuoka general hospital, and then divided into two groups: concomitant administration of clarithromycin group and non-concomitant group. The Proportions of patients experiencing grade 4 neutropenia between the two groups was compared by the chi-square test. Potential risk factors associated with grade 4 neutropenia were explored by the univariate and multivariate logistic regression analyses. Results: A total of 158 patients with NSCLC were analyzed. The incidence of grade 4 neutropenia was more frequently detected in patients with clarithromycin than without clarithromycin (63.2 vs. 35.3%; P = 0.025). The following risk factors were found in the univariate analysis and included into the multivariate analysis: pretreatment absolute neutrophil counts, pretreatment total bilirubin levels, co-administration of clarithromycin, female gender, and pretreatment albumin levels. The multivariate analysis showed that co-administration of clarithromycin (odds ratio [OR] 4.98; 95% confidence interval [CI] 1.66-14.96), female gender (OR 2.75; 95%CI 1.11-6.82), and pretreatment absolute neutrophil counts (OR 2.62; 95%CI 1.25-5.50) increased grade 4 neutropenia. Conclusions: The present study showed that concomitant administration of clarithromycin potentiated docetaxel-induced severe myelosuppression. This analysis suggests that patients with co-administration of clarithromycin, pretreatment absolute neutrophil counts and female gender might be risk factors for the incidence of grade 4 neutropenia." @default.
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- W2063485354 date "2013-11-01" @default.
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- W2063485354 title "A Retrospective Analysis of Neutropenia in Patients Receiving Concomitant Administration of Docetaxel and Clarithromycin" @default.
- W2063485354 doi "https://doi.org/10.1093/annonc/mdt460.37" @default.
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