Drug-drug interactions (DDIs) are increasingly common in aging populations. Although many studies address potential DDIs, few explore clinically manifested DDIs. The objective of this study was to examine the prevalence and characteristics of potential and clinically manifested DDIs in patients admitted to the hospital. This cross-sectional observational study analyzed consecutive hospital admissions following an emergency department visit in 2018. The cases with at least two medications prior to admission in the medication history were included. Medication history prior to admission was screened for potential DDIs using Micromedex, Uptodate and Stockley drug interaction databases. Potential DDIs were defined as those detected by at least one drug interaction database with moderate or greater severity. Clinically manifested DDIs were defined as those linked to adverse drug events. Of 1,252 eligible patients, 968 met the inclusion criteria (median age: 75, median number of medications: 7). A total of 7801 potential DDIs were identified in 89
Antithrombotic therapy is central to the prevention of thromboembolic and ischaemic events in patients with coronary artery disease, atrial fibrillation, and after percutaneous coronary intervention, but is accompanied by an increased risk of gastrointestinal bleeding (GIB). Proton pump inhibitors (PPIs) can reduce upper GIB, although their optimal use across different antithrombotic regimens, potential drug interactions, and inability to prevent lower GIB remain clinically relevant concerns. This structured narrative review examines PPI co-therapy in patients receiving antiplatelet agents, oral anticoagulants, or combined antithrombotic treatment. MEDLINE, Embase, and the Cochrane Library were searched from inception to August 2026, supplemented by contemporary cardiology and gastroenterology guidelines. Randomized trials, systematic reviews, meta-analyses, and large observational studies were prioritized. Evidence indicates that PPIs provide clinically meaningful protection against acid-related upper GIB, particularly in high-risk patients receiving aspirin-containing regimens, dual antiplatelet therapy, or intensified antithrombotic therapy, whereas evidence in isolated oral anticoagulation remains predominantly observational. PPI co-therapy should therefore be targeted according to gastrointestinal bleeding risk and antithrombotic intensity, with periodic reassessment as treatment changes, rather than used as universal gastrointestinal protection. • Proton pump inhibitors can reduce the risk of upper gastrointestinal bleeding in patients receiving antithrombotic therapy, but their benefit is greatest in patients with additional gastrointestinal bleeding risk factors • Their use should therefore be individualized according to gastrointestinal risk and the intensity of antithrombotic treatment rather than prescribed routinely to all patients • The need for gastroprotection should be reassessed whenever the antithrombotic regimen or the patient’s bleeding risk changes
Trastuzumab deruxtecan (T-DXd) and sacituzumab govitecan (SG) are both approved for metastatic breast cancer (mBC), and patients with HER2-low disease are often candidates for both, but the optimal sequence is undefined. This systematic review and meta-analysis compared outcomes of the second antibody–drug conjugate (ADC) by treatment sequence (SG→T-DXd versus T-DXd→SG). Following PRISMA (PROSPERO CRD420251250322), PubMed/MEDLINE, Scopus, Cochrane CENTRAL and major oncology conference proceedings were searched through December 2025 for studies of sequential T-DXd and SG in mBC. The primary endpoint was progression-free survival on the second ADC (PFS2). Hazard ratios (HRs) were obtained from patient-level data, published estimates or reconstructed Kaplan–Meier curves and pooled using a random-effects model. Study heterogeneity was assessed using the I² statistic. Risk of bias and certainty of evidence were assessed with ROBINS-I and GRADE. Of 694 records, 17 retrospective studies were included; seven (292 SG→T-DXd and 286 T-DXd→SG patients) contributed to the PFS2 meta-analysis. The pooled HR for T-DXd→SG versus SG→T-DXd was 1.54 (95
Estimating glucocorticoid exposure in patients with rheumatoid arthritis (RA) is challenging because Danish national registries provide data on redeemed prescriptions but lack information on daily drug dosage and intraarticular injections. This study compares different methods for estimating glucocorticoid exposure in patients with RA, utilizing data from national registries and hospital records. Estimated oral glucocorticoid dose was calculated from registry information, using three methods: (reverse) waiting time distribution ((r)WTD), defined daily dose (DDD), and 90 days average dose. Information on physician prescribed glucocorticoid dosage was gathered from hospital records from 585 patients with RA to validate estimated dose, in both an incident, and a mixed incident and prevalent cohort. Validation was compared using percentage relative difference (RD), limit of agreement ratio (LOAR), sensitivity, and specificity. For glucocorticoid injections, binary agreement between hospital records and registries was presented. Among included models, rWTD performed best for incident populations when comparing physician prescribed glucocorticoid exposure, with registry information (RD: -0.07
