Importance of pharmacovigilance in the era of small molecules: Role of pharmacist consultation with ixazomib (IXA) in multiple myeloma (MM).

Abstract

8058Background: IXA is an oral proteasome inhibitor recently approved for MM. Due to IXA’s Cytochrome P450 CYP3A4 and 1A2 metabolism, clinical trials of IXA excluded pts on 3A4 and 1A2 strong inhibitors and inducers. We examined the role of pharmacist review of potential drug-drug interactions (DDIs) in patients (pts) initiating IXA. Methods: Clinical trial pts receiving IXA between 1/2012 and 12/2015 for relapsed MM (NCT01415882; IXA, dexamethasone) and newly diagnosed MM (NCT01864018; IXA, dexamethasone, cyclophosphamide) were included. A pharmacist medication review for DDI was performed prior to IXA initiation. Baseline characteristics, concomitant medications, and toxicities were recorded. Results: Ninety-seven pts were included; 1 pt was excluded due to use of clarithromycin, a strong CYP3A4 inhibitor. Median age was 69 years (41-88) and 57% were male. The median number of concomitant medications was 9 (1-23). Four (4%) pts had potential CYP-mediated DDIs. One pt was on a strong CYP3A4 inducer (prim...