Originally published by our sister publication Specialty Pharmacy Continuum
By Myles Starr
The range of drugs that health-system specialty pharmacies dispense to treat inflammatory conditions has been rapidly increasing. Specialty pharmacists are responding by playing a key role in protecting patients from safety risks associated with these medications, according to a new study presented at the ASHP Pharmacy Futures 2025 meeting, in Charlotte, N.C.
“[We found that] over 60% of pharmacist interventions are safety-related, often addressing potential adverse medication events, such as dose adjustments in response to acute conditions like infections or newly diagnosed illnesses,” lead author Morgan Petitte, PharmD, MBA, BCOP, a pharmacy outcomes coordinator at West Virginia University Health (WVUH) Specialty Pharmacy and Home Infusion, in Morgantown, told Pharmacy Practice News.
Dr. Petitte and her colleagues at WVUH adopted the use of the Medication Therapy Problem Categories Framework, created by the Pharmacy Quality Alliance, to document and evaluate the most commonly performed pharmacist interventions among patients prescribed drugs for inflammatory conditions between January and March 2025.
During the study, the researchers documented 110 clinical interventions by pharmacists caring for patients receiving medications for inflammatory conditions. More than half of interventions (63%) were related to safety, while interventions related to indication, adherence and efficacy represented 3%, 14% and 20% of the interventions, respectively. Interventions were most common among patients with rheumatoid arthritis (23), followed by those with inflammatory bowel disease (19), psoriatic arthritis (18), dermatitis (15), psoriasis (13), other inflammatory conditions (13), spondyloarthritis (8) and juvenile idiopathic arthritis (1).
Dr. Petitte noted safety concerns were the most common reason for pharmacists intervening in a patient’s therapy (17/23 interventions). In particular, there often were calls to hold therapy if an infection such as cellulitis or an upper respiratory viral infection was present.
For patients with IBD, most interventions were also related to safety (13/21). The most common safety interventions were related to decreases in hemoglobin and absolute lymphocyte counts associated with Janus kinase inhibitor treatment and elevated liver function tests following interleukin 12 and 23 inhibitor therapy, Dr. Petitte noted. However, she added there were also some recommendations to hold therapy during infection.
Although there were few interventions related to efficacy among the majority of conditions treated in the study, patients with dermatitis were an outlier. More than one-third of interventions in this group (6/15) were related to efficacy. Dr. Petitte explained that most of these interventions were among pediatric patients treated with dupilumab (Dupixent, Sanofi Regeneron). “Dupilumab dosing is complex, as there are many indications along with different doses based on both weight and age,” she said. “The dosing also often requires a loading dose followed by a maintenance dose. Most interventions were optimizing the dose of dupilumab to include the correct loading and/or maintenance dose for the patient’s age and weight.”
In conclusion, Dr. Petitte noted, “pharmacist interventions likely improved patient care through optimizing therapy management, addressing safety concerns and improving adherence, which we hope led to both improved patient outcomes and cost savings.” She cautioned, however, that future research is needed to quantify these outcomes.
Dr. Petitte reported no relevant financial disclosures.