Research on Drug Repurposing of Benzimidazole Anthelmintics as Anti-cancer Agents

송보미 조선대학교 임상약학대학원 2022 국내석사

In recent decades, a chemical group of benzimidazoles has shown significant promise as repurposing cancer therapy, among other drugs. Besides, repurposing of anthelmintics for cancer treatment caught attention of cancer patients in 2019 in South Korea because of a huge controversy triggered by successful experiences of Joe Tippens, and anthelmintics are used by many patients in cancer treatment in South Korea. Nevertheless, there have been few studies about developing status of benzimidazoles as anti-cancer agents. For that reason, an extensive review on the preclinical and clinical studies for benzimidazoles was conducted in this thesis, and additionally, a perception study for cancer treatments among cancer patients was also performed. In the first part, the current thesis aimed to reveal the possibilities and limitations of the anti-cancer effects of benzimidazole anthelmintics, by exploring a variety of studies, and suggested ways to overcome the limitations of benzimidazle anthelmintics, for possible application as repurposed drugs. The review included studies on anti-cancer effects of 11 benzimidazoles. In three sections for preclinical anti-cancer effects, clinical anti-cancer effects, and pharmacokinetic properties, the properties of each benzimidazole were examined and key properties were elucidated. Notably, although many preclinical studies have demonstrated the anti-cancer effects of benzimidazoles, there is limited evidence regarding their prominent effects in clinical settings. It was presumed that this was because the clinical trials conducted on benzimidazoles, failed to restrict their participants with specific criteria including cancer entities and cancer stages, due to the reason that main targets and the multiple anti-cancer properties of them have not clearly clarified yet. In addition, these drugs face the limitation of low bioavailability, resulting in insufficient concentration levels. In conclusion, additional efforts in the form of further studies on whole anti-cancer pathways and development strategies, including formulations, are required to repurpose benzimidazoles as anti-cancer agents. In the second part, a cross-sectional survey was conducted because adequate data on their experiences or perceptions is lacking although anthelmintics are used by many patients with cancers. The survey investigated the repercussions of anthelmintics for cancer treatment and evaluated their effectiveness and adverse effects. It included 86 cancer patients, aged 19 years and above, who underwent anthelmintic therapy for cancer. They were recruited from two online communities in South Korea, and a structural questionnaire was provided online. The survey results showed that cancer patients under anthelmintics therapy for cancer in South Korea were mostly in their advanced stages and had started the treatment in 2019. More than one-third of cancer patients had taken anthelmintics during their chemotherapy, and 97% of them did not inform clinicians. These participants had a positive perception towards the effectiveness of anthelmintics, as it improved their physical condition (42.9%). Examination of adverse effects of anthelmintics showed that more than two-thirds of the subjects did not experience adverse effect, and gastrointestinal side effects were mostly reported. In conclusion, it might be worth evaluating the benefits and risks of anthelmintics in cancer treatment through further clinical trials considering perceptions among the patients. Communication between the clinicians and cancer patients needs to be enhanced regarding the use of anthelmintics to prevent adverse effects. Through these two parts, it was concluded that although benzimidazoles had in vitro and in vivo anti-cancer effects, data for anti-cancer effects and safety in clinical settings are still not enough. Therefore, for drug repurposing of benzimidazoles as anti-cancer agents, more rigorous studies need to be performed. In addition, although many cancer patients had a positive perception towards the effectiveness of anthelmintics, it needs careful attention because diverse adverse effects might occur from taking drugs without consultation with doctors. Furthermore, it is required the more active involvement of government in order to present evidence-based guidelines for social issues regarding drug uses. 구충제로 사용되고 있는 벤지미다졸 계열의 약물 성분은 최근 수십 년 동안 항암 치료 목적의 약물 재창출 연구 분야에서도 활발히 연구가 진행되어 왔다. 특히, 2019년 한국에서는 조 티펜스의 성공적인 암 치료 경험담이 알려짐으로써 암 치료를 위한 구충제 복용에 암 환자들이 관심을 갖게 되었고, 실제로 많은 환자들이 구충제로 암 치료를 하는 상황이 초래되었다. 그럼에도 불구하고 벤지미다졸 계열 구충제를 항암제로 개발하고자 하는 현황 및 사용실태에 대해 조사가 부족했다. 따라서 본 연구에서는 벤지미다졸 계열 구충제의 비임상 및 임상 연구에 대한 문헌 조사를 수행하였으며, 추가적으로 벤지미다졸 계열의 구충제를 복용한 암환자를 대상으로 인식도 조사를 실시하였다. 첫 번째 연구는 문헌 고찰 연구로 벤지미다졸 성분의 구충제가 가진 항암 효능 및 항암제로서 약물재창출 과정 시 관찰되는 한계를 분석하고, 이의 극복방법을 고찰하고자 하였다. 주로 사용되는 11개의 벤지미다졸 약물의 비임상 및 임상 항암 효능, 약동학적 특성을 검토하였다. 여러 비임상 연구에서 벤지미다졸 계열의 항암 효과가 다수 보고되었지만, 실제 임상 연구에서는 현저한 효과가 관찰된 사례가 없었다. 그 이유 중 첫 번째로, 벤지미다졸의 약물 표적 및 항암 특성이 완전하게 규명되지 않았기 때문에 임상 시험에서 참여자 모집 시 암종 및 병기가 구체화되지 못했기 때문인 것으로 사료된다. 두 번째, 벤지미다졸의 낮은 생체이용률로 인해 충분한 약물 농도에 도달하지 못하는 한계를 갖고 있다. 결론적으로, 벤지미다졸 구충제의 항암제로 약물 재창출을 위해서는 벤지미다졸 약물의 항암효과 기전의 구체화와 함께 물리적 특성으로 인한 한계를 극복하기 위해 투여 경로 및 제형 등에 대한 추가적인 연구가 필요할 것으로 보인다. 두 번째 연구는 단면조사연구로 진행되었다. 다수의 암 환자들이 구충제를 항암 목적으로 사용하고 있음에도 이들의 경험이나 인식에 대한 조사가 수행된 바가 없다. 따라서 본 연구에서는 항암 목적으로 구충제를 사용한 방법과 치료 효과 및 이상반응에 대한 인식을 평가하였다. 설문은 항암 목적으로 약물 사용 경험이 있는 만 19세 이상의 암 환자 86명을 대상으로 실시하였다. 참여자는 한국의 온라인 커뮤니티 두 곳에서 모집하였고, 구조화된 설문지를 온라인으로 제공하여 시행하였다. 설문 결과, 한국에서 구충제를 이용하여 암을 치료한 환자 다수는 대부분 말기 환자였으며, 2019년에 구충제 복용을 시작한 것으로 나타났다. 3분의 1 이상의 암 환자는 기존 항암요법 기간에 구충제를 복용하였고, 참여자의 97%가 구충제 복용에 대해 주치의와 상의하지 않은 것으로 밝혀졌다. 참여자의 대부분은 구충제의 치료 효과에 대해 긍정적인 인식을 가지고 있었고, 이는 컨디션 향상(42.9%)을 주된 이유로 꼽았다. 구충제 복용 후 나타난 이상반응은 참여자의 약 3분의 1에서 관찰되었으며 나머지 3분의 2 이상은 이상반응을 경험하지 않았고 가장 주된 이상반응은 위장관 장해였다. 결론적으로, 구충제 사용에 대한 환자들의 긍정적인 인식이 큰 것으로 조사되었으나 참여자의 3분의 1 이상이 이상반응을 경험한 것을 볼 때, 암 치료의 이익과 위험을 보다 정확히 평가할 필요가 있으며 이를 위해 추가적인 임상시험을 시행할 필요가 있을 것으로 보인다. 그리고 구충제 사용에 따른 이상 반응을 방지할 수 있도록 주치의와 환자 간 소통도 향상될 필요가 있다. 이 두 개의 연구를 종합하면, 벤지미다졸은 비임상 시험에서 항암 효과를 나타내는 것으로 보고되고 있으나, 임상연구를 통한 항암 효과 및 안전성에 관한 자료는 부족한 실정이다. 따라서 벤지미다졸 약물의 항암제로의 약물 재창출을 위해서는 추가적인 비임상 및 임상 연구가 수행되어야 한다. 또한 다수의 암환자들이 약물사용에 긍정적 인식을 가지고 있음에도 전문가와 상담없이 약물을 복용할 경우 여러 이상 반응들이 나타날 수 있기 때문에 보다 세밀한 주의가 필요하다. 마지막으로 약물 사용에 대한 사회적 이슈가 있는 경우에 보건 당국의 보다 적극적이고 선제적인 대응을 통하여 증거 기반의 사용 가이드라인을 제시할 필요가 있다고 판단된다.

프로폴리스의 약리효능에 대한 고찰: 항암효능을 중심으로

문정원 조선대학교 임상약학대학원 2018 국내석사

프로폴리스는 벌들이 생성하는 천연 방부 물질로 다양한 생리 활성작용으로 인하여 질병을 예방, 치료하는 약제로 오랫동안 이용되어 왔다. 최근 프로폴리스의 유효성분들이 동정되고 이들의 약리 효능 및 생체 내 기전에 대한 연구가 활발히 진행 되고 있다. 본 연구 논문에서는 프로폴리스의 지금까지 연구되어 있는 생체 내 유효 성분 및 작용기전에 대해 고찰해보고자 한다. 특히 프로폴리스의 다양한 장기에서의 항암효능 및 조직재생 능력을 바탕으로 항암제 또는 보조항암 화학 요법으로써 프로폴리스의 적용가능성을 탐색하며 이와 관련된 임상연구의 필요성을 제시하고자 한다. Propolis is a natural antiseptics produced by honeybees and has long been used to prevent and treat diseases because of its various physiological action. Lately, the active ingredients in propolis have been identified and their pharmacokinetics and mechanisms are under study. In this paper, we will review the active ingredient in vitro/in vivo and the mechanism of action that is studied so far in the Propolis. In particular, we explores the applicability of the propolis as a chemotherapy or as a supplementary chemotherapy based on its efficacy in various organs and its associated clinical studies.

국내 3차 병원에 내원한 다낭성 난소 증후군 환자의 약물치료요법 관리 및 추적 관찰분석

유지혜 조선대학교 임상약학대학원 2023 국내석사

PCOS is disease caused by excessive androgen secretion activity in the ovary due to hypothalamic-pituitary-ovarian hormone abnormalities. It occurs in 6~8% of women of childbearing age, and PCOS patients It is a gradually increasing trend. In this study, based on domestic and foreign PCOS treatment guidelines, we retrospectively investigate the treatment status of patients who visited a domestic tertiary hospital to analyze/evaluate the use patterns and safety of drugs. For patients diagnosed with PCOS between July 2014 and September 2022, patients younger than 13 years and patients not receiving medication were excluded. Patients aged 21 years or younger were divided into a youth group and patients aged 22 years or older were divided into an adult group and divided into two groups for statistical comparative analysis. The total number of patients was 212, including 105 adolescents (49.5%) and 107 adults (50.5%). Comorbidities were ovarian cyst 20 (9.4%), endometriosis 19 (9%), diabetes 14 (6.6%), thyroid dysfunction 12 (5.7%), hypertension/dyslipidemia 10 each (4.7%), followed by androgenic alopecia in 6 patients (2.8%). A total of 98 patients (46.2%) showed polycystic ovarian findings on ultrasonography, and the clinical symptoms were oligomenorrhea in 91 (42.9%), amenorrhea in 72 (34%), hirsutism in 36 (17%), and acne 24 (11.3%), followed by 10 (4.7%) infertility. During the study period, 114 patients (53.8%) were prescribed MPA, 66 patients (31.1%) were oral contraceptives, and 17 patients (8%) were concurrently prescribed MPA and oral contraceptives. Regarding PCOS, 45 patients (21.2%) changed prescriptions, 10 patients (22.2%) were changed due to side effects, and 8 patients (17.8%) were changed due to lack of effect. A total of 5 patients (2.4%) discontinued the drug only in adults. Fifty patients (23.6%) who visited the hospital during the study period and received a drug prescription and did not return to the hospital were not followed up. Adverse drug reactions occurred in 15 patients (7.1%), 5 adolescents (4.8%) and 10 adults (9.3%). Abnormal bleeding, depression, nausea, weight gain, and breast tenderness were reported. Nausea was the most common in 8 patients (3.8%), followed by breast tenderness in 6 patients (2.8%). In conclusion, this study was able to learn about the need for treatment of PCOS, which is considered a chronic disease, and the need for long-term drug management. The understanding of physiological changes related to reproduction in adolescents after menarche and the accurate diagnosis of PCOS and the appropriate drug use accordingly reduce complications of later infertility and ultimately reduce the prevalence of PCOS and accompanying metabolic diseases in adults is considered essential.

간성혼수 증상을 보이는 간질환 환자들에 있어서 분지사슬 아미노산의 투여 효과

박호영 조선대학교 임상약학대학원 2021 국내석사

Background : The therapeutic efficacy of BCAA in liver disease patients with hepatic encephalopathy is still controversial. Therefore, this study aimed to evaluate the effect of BCAA in patients with hepatic encephalopathy on hospitalized patients in Korea. Method : We retrospectively reviewed a total of 72 cases based on electronic medical records in a tertiary hospital from January 1, 2010, to December 31, 2019. Those patients were classified into three groups; lactulose only group, lactulose with intravenous BCAA administration group, and lactulose with oral rifaximin administration group. Then we evaluated the clinical parameters such as elapsed time from the administration of these medications to the recovery of consciousness, changes of albumin levels as well as child-pugh score before and after the treatment, and hospitalization periods. Results : Among the 72 cases, 41 cases were assigned to the lactulose only group, 6 cases to the lactulose with intravenous BCAA administration group, and 25 cases to the lactulose with oral rifaximin administration group. Patients of the lactulose with intravenous BCAA group recovered their consciousness significantly faster than those of the lactulose only group (p<0.01). However, there was no statistically significant difference in albumin levels, Child-Pugh score, and hospitalization periods among those groups. Conclusion : We suggest that the co-administration of lactulose and intravenous BCAA is beneficial in liver disease patients with hepatic encephalopathy.

지역약국에서 다제 처방약물을 복용하는 만성질환 환자에서 OTC 약물의 사용 패턴 분석

김현정 조선대학교 임상약학대학원 2016 국내석사

Abstract: Along with a growing population of senior citizens, the number of patients with chronic disease is also on the increase. Chronic disease is a medical condition that requires continuous drug treatments due to the symptoms which last longer than three months without any sign of improvements. Chronic disease includes cardiovascular, musculoskeletal, endocrine, respiratory systems and cancers. The increase in life expectancy that resulted from improvements of medical technologies and changes in lifestyle are the main causes of prevalence of chronic disease. For these reasons, the rate of patients taking multiple medications is increasing. The purpose of this study is to analyze and evaluate the patterns of OTC drug usage taken from the survey of patients taking multiple medications in community pharmacy, and to provide appropriate database related to efficiency and safeness of taking OTC drugs. Our pharmacy posted a reserch notice (Among chronic disease patients who visited this pharmacy from September of 2014 to August of 2015, patients who are older than 18 years old and taking more than two drugs continuously for more than three months) and surveyed selected 345 patients among 587 volunteers, who corresponded to study inclusion criterion and prospectively analyzed OTC usage patterns. The survey was approved by the IRB and was collected and analyzed after coding for the protection of personal privacy. Inappropriate and unnecessary medication uses were evaluated by 2012 Beers Criteria for patients over 65 years old who were subjected to the survey. Drug-Drug interactions between prescribed medicines and OTC drugs were analyzed by using clinical medical pharmacology database, Micromedex. An analyzed result of OTC drug usage patterns by age and gender, antipyretic, anti-inflammatory drugs (150 patients, 43.5%) were the most used OTC drugs by gender followed by anti-histamine drugs (89 patients, 25.8%), digestive medicine (62 patients,18%), antitussive expectorants (47 patients,13.6%) and antacid (33 patients, 9.6%). Patients under 65 years old took more OTC drugs than the others for the ease of pain. Frequently used OTC ingredients were acetaminophen, followed by caffeine and chlorpheniramine. An analyzed result of patients over 65 years old using inappropriate drugs, antigastric-secretion drugs ranked highest followed by NSAIDs and antiplatelet agent, according to 2012 Beers Criteria. Using MicromedexⓇ Solutions, amlodipine and ibuprofen, thiazide and ibuprofen found out to be the potential risk factors of the interaction between prescribed drugs-OTC drugs. Continuous monitoring and active medication counselling are needed for the prevention of inappropriate interaction between multiple medicines and OTC drugs among patients taking multiple medications. The role of community pharmacy for chronic disease patients is considered to be an efficient disease management and a health care cost reducing factor.

국내 3차 병원에서 HIV 환자의 약물치료요법 관리와 추적 관찰

박미선 조선대학교 임상약학대학원 2017 국내석사

The use patterns of human immunodeficiency virus (HIV) drugs had been rapidly evolved due to new antiretroviral drugs and recently revised HIV/AIDS guidelines. However, there are limited studies regarding their prescription patterns, efficacy, and safety according to the new guidelines in Korea. The aims of this study were to analyze the prescription patterns of medications for HIV and to perform follow-up evaluation. This study was retrospectively conducted through electronic medical records (EMR). HIV patients who visited the tertiary hospital between October 2011 to September 2017 were included in the study. One hundred and eighty-three HIV patients were selected for the analysis. The mean age was 47.3 ± 12.4 years, and 159 (86.9%) were males. The combination of nucleoside reverse transcriptase inhibitors (NRTIs)/protease inhibitors (PIs) was most frequently prescribed during the study period; however, its frequency had been gradually decreased from 54.6% at baseline to 41.6% at month 72. The second most commonly prescribed combination was NRTIs/PIs/integrase strand transfer inhibitors (INSTIs) which had been gradually increased. Specifically, ABC/3TC and TDF/FTC were used most frequency during the whole study period. ZDV/3TC use had been gradually declined from 19.7% at baseline to 8.7% at month 72, whereas TAF/FTC use had been gradually increased from 2.7% at baseline to 21.7% at month 72. At the beginning of follow-up, the success rate of HIV suppression (HIV-1 RNA < 50 copies/mL) was 86.7% in ART-experienced patients and 65.7% in ART-naive patients, but there was no difference after 12 months and showed an average success rate of HIV suppression exceeding 80% (excluding 30 month). Among study patients, 126 (68.9%) experienced adverse drug reactions. Skin reactions (23%), such as rash, itching, and pigmentation, most commonly occurred followed by vomiting (10.9%), fatigue (9.8%) and diarrhea (9.3%). Total cholesterol level was 167.5 ± 40.4 mg/dL at baseline, but was 189.3 ± 43.3 mg/dL at month 72. Glucose level was also 117.2 ± 43.4 mg/dL at the beginning of treatment, but was increased to 186.4 ± 177.7 mg/dL at month 72. The number of CD4+ T cells increased from 316 ± 22 cells/μL at baseline to 687 ± 340 cells/μL at month 72. Gastrointestinal and metabolic drugs were co-prescribed more commonly with ART in patients ≥ 50 years (72.2%) than those < 50 years (46.2%) (p<0.001). Dermatologic drugs (p=0.008), cardiovascular drugs (p=0.023), blood and hematopoietic drugs (p=0.023), and genitourinary and sex hormone drugs (p=0.009) were also more frequently used with statistical significance in patients ≥ 50 years than those < 50 years. In conclusion, it was confirmed that single tablet regimen (STR) formulation and new drug were changed according to the new guidelines. It is considered that a study should be needed to confirm the efficacy and safety of new HIV drugs on Korean. Further related studies in multicenters are needed to confirm this study. Also, it is necessary to expand the roles of pharmacists to monitor appropriate drug selection, drug interaction, and side effects.

Drug utilization review 시행 전후 3차 의료기관에서의 노인주의약품 외래처방 현황 분석

조여향 조선대학교 임상약학대학원 2018 국내석사

Objective: South Korea made a list of inappropriate medications for elderly patients in 2015 and have induced medical team to use proper medication by using drug utilization review (DUR) system. It's been three years since the system was introduced, but related studies have rarely been conducted. The aim of this study is to evaluate the DUR system on potentially inappropriate medications for elderly patients. Methods: The data of inappropriate medications for elderly patients(≥65 years) who received medical treatment between March 1st and May 31st in 2015 (before applying DUR) and who received medical treatment between March 1st and May 31st in 2018 (after applying DUR) were retrospectively collected from electronic medical record. Results: The prescriptions of inappropriate medications decreased from 3,716(7.7%) to 3,857(6.9%). The most frequently prescribed medications were amitriptyline (before DUR 43.8%, after DUR 35.5%) and clonazepam (before DUR 38.0%, after DUR 45.6%). Conclusion: Inappropriate medications of elderly patients were significantly decreased(Ρ<0.001) after DUR was introduced. And the wider information of inappropriate medications are needed to be offered in various ways.

국내 요양병원에서 노인 환자들의 다제약물복용 실태와 2003/2012년 Beers Criteria에 따른 처방약물의 적절성 분석

박기현 조선대학교 임상약학대학원 2016 국내석사

As the population is aging, the prevalence of chronic diseases is increasing and polypharmacy is becoming essential in the elderly. The unnecessary medication use can increase the risk of potentially inappropriate medications (PIMs), resulting in adverse drug reaction. Beers Criteria published by The American Geriatrics Society (AGS) are used to identify and assess the appropriateness of prescription drugs in elderly patients. The aim of this study was to provide a optimal drug therapy which secures effectiveness and safeness in elderly patients by analyzing polypharmacy and the appropriateness of prescription drugs according to Beers Criteria 2003 and 2012. This study was conducted with patients aged over 65 years who received two or more medications in a long term care facility from March 2014 to August 2015. This study was retrospectively conducted through electronic medical record (EMR). Prescription drugs of the patients were investigated on 14th day after their hospitalization. We defined polypharmacy as taking two or more medications. PIMs were confirmed by the Beers Criteria 2003/2012 and subsequently the PIMs were compared and analyzed by ARS and FRMS. We investigated drug interactions among all prescription drugs by Micromedex. Of the total 544 patients, 216 patients were selected and the average number of medication was 5.3 (±2.7). We found that the number of comorbidity increased in accordance with the number of polypharmacy (p<0.001). The patients who received PIMs by the Beers Criteria 2003 and 2012 were 151 (69.9%) and 185 (85.6%), respectively. We found an association between polypharmacy and PIMs (p<0.001). The patients who received PIMs by ARS among the patients taking PIMs by the Beers Criteria 2003 and 2012 were 110 (72.8%) and 129 (69.7%), respectively. The patients who received PIMs by FRMS among the PIMs-taken patients by the Beers Criteria 2003 and 2012 were 79 (52.3%) and 96 (51.9%), respectively (p<0.001). The drug interactions that can cause potential risks were identified in 18 cases. The use of medication in elderly patients should be monitored carefully because polypharmacy can increase the risk of PIMs, leading to adverse drug reaction. This study was conducted in one specific long term care facility, which means that it does not represent the whole long term care facility. Thus, a follow-up study is required to provide an optimal therapy which secures effectiveness and safeness in elderly patients.

방문약료를 통해 수거한 가정내 폐의약품 분석과 감소방안 모색

황지원 조선대학교 임상약학대학원 2021 국내석사

최근 인구 노령화에 따른 다제약물복용 만성질환자의 증가로 발생량이 증가하고 있는 폐의약품(Unused and expired medications, UEM)은 건강보험재정 손실 및 환경오염 문제까지 유발하는 것으로 보고되어 사회적 관심이 증대되고 있는 상황이다. 본 연구는 방문약료를 통해 환자가 가정에서 보관 중인 폐의약품을 적극적으로 수집하고 그 특성을 분석하고자 한다. 본 연구는 2020년 7월 15일부터 2020년 12월 20일까지 진행되었다. 연구대상은 전주, 익산에 거주하며 대표적 13개 만성질환 중 1개 이상을 보유하고 10개 이상 약물을 정기적으로 복용하는 환자로 2020년도 다제약물관리사업에 참여한 환자 233명을 대상으로 진행하였다. 연구대상자의 기본 특성, 수거된 폐의약품 중 전문의약품의 특성, 비전문의약품의 특성을 분석하였다. 모든 결과는 빈도와 분율(%), 평균±표준편차로 표기하였다. 연구결과 전체 대상자 중 폐의약품 발생률은 60.5%, 1인당 복용 중인 처방의약품의 개수는 대략 17개, 총 폐의약품 개수는 108개, 폐의약품의 효능 계열 수는 8개, 폐의약품의 총 비용은 38,205원에 달했다. 본 연구에서 최초로 시도한 방문약료를 통한 적극적인 폐의약품 수거는 환자가 지역약국을 방문하여 폐기하는 수동적 활동 대비 폐의약품의 적절한 관리에 보다 더 기여할 것으로 보인다. Unused and expired medications (UEM) have been reported to induce financial loss of health insurance and environmental pollution. The purpose of this study is to actively collect and analyze the characteristics of UEM stored at home by patients through home pharmaceutical care service. The study was conducted from July 15 to December 20, 2020. The subjects of the study were patients who had one or more of the 13 typical chronic diseases, and took 10 or more drugs regularly. We analyzed the primary characteristics of the study subjects and the characteristics of the collected UEM. As a results, among all subjects, the incidence rate of UEM was 60.5%, the number of prescription medicine taken per person was about 17, the total number of UEM was 108, and the number of therapeutic class for UEM was 8. The total cost of UEM reached 38,205 won(₩). As for the collected UEM, gastrointestinal tract-related drugs such as gastrointestinal motility regulators and gastric acid secretion inhibitors were the most common. There was a statistically significant correlation between the number of prescription drugs in use and the total number of UEM (p=0.039). Compared to the results of UEM collected passively at local pharmacies, the total number of UEM increased by 6.75 times and the total UEM price increased by 13.21 times. In conclusion, active collection of UEM through home pharmaceutical care service showed better results than the passive collection. And the findings of this study are expected to contribute to the proper management of UEM.