Original Research
Sunday, November 12, 2023
12:45 PM–02:15 PM
Abstract
Introduction:
Glucose-6-phosphate dehydrogenase deficiency (G6PDD) is one of the most common enzyme deficiencies. The resulting hemolytic anemia is largely triggered by certain medications. Although routine testing for G6PDD prior to initiation of hydroxychloroquine (HCQ) is not endorsed by clinical guidelines, careful use in patients with G6PDD is recommended on the package insert.
Research Question or Hypothesis:
We sought to quantify the frequency of G6PD deficient patients at Cleveland Clinic Abu Dhabi (CCAD), as well as to quantify the frequency of G6PD-deficient patients with hemolysis attributed to HCQ use in a sample of an Emirati population.
Study Design:
A retrospective observational chart review was performed at our quaternary care hospital.
Methods:
We performed a retrospective chart review to identify all eligible patients who were screened for G6PDD, and who were prescribed either HCQ or nitrofurantoin between 2015 and 2020. Case records were analyzed for G6PDD, HCQ and nitrofurantoin use, length of exposure to the drugs, demographic characteristics, and laboratory evidence of hemolysis.
Results:
Out of 2986 patients who were tested for G6PD level, 512 (17.14%) were G6PDD. A total of 450 patients were excluded and 61 G6PDD patients, with either HCQ or nitrofurantoin prescriptions, were analyzed. Of those, none showed evidence of hemolysis due to drug exposure.
Conclusion:
Considering the paucity of available research studies from the region, the present study represents the first to look at the use of HCQ and nitrofurantoin in a G6PDD cohort. Our results highlight a potential absence of a causality between the hemolysis phenotype in a G6PDD patient and both HCQ and nitrofurantoin use. Which suggest the possibility of no necessary routine testing for G6PDD before initiating either medication. Larger investigations, as well as studying the role of genotypes and specific variants contribution to hemolytic risks, especially after HCQ administration, are also warranted.
Presenting Author
Wasim Elnekidy PharmD, BCPS, BCACPCleveland Clinic Abu Dhabi
Authors
Emna Abidi PhD
Cleveland Clinic Abu Dhabi
Tamara Kadi BSPharm
Cleveland Clinic Abu Dhabi
Mohamad Masri MD, F.A.C.P.
Cleveland Clinic Abu Dhabi
Ahmad Nusair MD
Marshall University
Rania El Lababidi PharmD, BCPS (AQ-ID), AAHIVP
Cleveland Clinic Abu Dhabi