Yu Ko

Publications (2)4.64 Total impact

• Article: Clinical Impact of Drug-Drug Interaction Between Aspirin and Prednisolone at a Cancer Center.

  Narendran Koomanan, Yu Ko, Wei-Peng Yong, Raymond Ng, Yuet-Peng Wong, Siew-Woon Lim, Agus Salim, Alexandre Chan
  [show abstract] [hide abstract]
  ABSTRACT: BACKGROUND: Adverse gastrointestinal (GI) events are complications in aspirin and prednisolone cotherapy. The prevalence of adverse GI events would be expected to be increased with cotherapy due to the overlapping toxicities of the 2 drugs. However, there is a dearth of literature investigating how often this interaction causes clinically important adverse GI events. OBJECTIVES: This retrospective study aimed to determine the prevalence of adverse GI events associated with the coadministration of aspirin and prednisolone. The use of gastroprotectant agents was also studied. METHODS: The medical records of patients with cancer prescribed aspirin and prednisolone therapy between January 2007 and June 2011 were analyzed. The duration of aspirin-prednisolone overlap, prevalence of adverse GI events, and details on the concurrent use of other medications were evaluated. RESULTS: The study included data from 142 patients (male, 64.8%; mean [SD] age, 67.4 [11.0] years). A total of 78.9% of the patients were on some form of gastroprotectant, the most common class of which was proton pump inhibitors. The prevalence of adverse GI events was 4.2% (6 patients). Four patients had presented with GI symptoms (abdominal pain, diarrhea, dysphagia, and vomiting); 3 patients had signs of GI injury (duodenal ulcers, iron deficiency anemia, and a Mallory-Weiss tear). The Naranjo algorithm classified 5 patients experienced possible adverse drug reactions (ADRs), and 1 as a probable ADR. CONCLUSION: Our study found that the prevalence of adverse GI events was low and managed to establish a weak association between the occurrence of events and the coadministration of aspirin and prednisolone. This finding, together with the concurrent prescription of gastroprotectants, suggests that the clinical impact of the aspirin and prednisolone DDI is minimal.
  Clinical Therapeutics 11/2012; · 2.32 Impact Factor
• Article: Prevalence of the coprescription of clinically important interacting drug combinations involving oral anticancer agents in singapore: a retrospective database study.

  Yu Ko, Sze-Ling Daphne Tan, Alexandre Chan, Yuet-Peng Wong, Wei-Peng Yong, Raymond Chee-Hui Ng, Siew-Woon Lim, Agus Salim
  [show abstract] [hide abstract]
  ABSTRACT: There has been a recent increase in the availability and use of oral anticancer agents (OAAs). Drug-drug interactions (DDIs) involving OAAs pose a major concern in oncology practice due to these drugs' narrow therapeutic indices and potential for compromised efficacy and fatal adverse events. To assess the prevalence of the coprescription of potentially interacting drug combinations involving OAAs in Singapore. A retrospective review of physicians' electronic prescription records between the years 2007 and 2009 was performed in the largest cancer center in Singapore. An overall prevalence rate of potential DDIs and a prevalence rate for each individual DDI pair were calculated. Logistic regression was used to identify risk factors for potential DDIs. Fifty-eight clinically significant DDIs were selected for evaluation from Drug Interaction Facts and Micromedex DrugDex. A total of 39,772 OAA prescriptions prescribed to 8837 patients were reviewed. Potential DDI coprescription was found in 5.4% of the patients on OAAs and in 4.7% of the OAA prescriptions. The drug pair prescribed to the largest number of patients was prednisolone and aspirin. About half (53.3%) of the observed DDIs were found on the same prescription. On multivariate analysis, older patients, males, and those taking prednisolone had a higher risk for potential DDIs. Although limited by the data available, the analysis of prescription records found that ∼5% of patients taking OAAs in Singapore were exposed to ≥1 potentially interacting drug combination.
  Clinical Therapeutics 07/2012; 34(8):1696-704. · 2.32 Impact Factor