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Mody H, Nair S, Rump A, Vaidya TR, Garrett TJ, Lesko L, Ait-Oudhia S. Identification of Novel and Early Biomarkers for Cisplatin-induced Nephrotoxicity and the Nephroprotective Role of Cimetidine using a Pharmacometabolomic-based Approach Coupled with In Vitro Toxicodynamic Modeling and Simulation. J Pharm Sci 2024; 113:268-277. [PMID: 37992870 DOI: 10.1016/j.xphs.2023.11.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 11/16/2023] [Accepted: 11/16/2023] [Indexed: 11/24/2023]
Abstract
Cisplatin is widely used for the treatment of various types of cancer. However, cisplatin-induced nephrotoxicity (CIN) is frequently observed in patients receiving cisplatin therapy which poses a challenge in its clinical utility. Currently used clinical biomarkers for CIN are not adequate for early detection of nephrotoxicity, hence there is a need to identify potential early biomarkers in predicting CIN. In the current study, a combination of in vitro toxicodynamic (TD) modeling and untargeted global metabolomics approach was used to identify novel potential metabolite biomarkers for early detection of CIN. In addition, we investigated the protective role of cimetidine (CIM), an inhibitor of the organic cation transporter 2 (OCT2), in suppressing CIN. We first characterized the time-course of nephrotoxic effects of cisplatin (CIS) and the protective effects of CIM in a human pseudo-immortalized renal proximal tubule epithelial cell line (RPTEC), SA7K cell line. Secondly, we used a mathematical cell-level, in vitro TD modeling approach to quantitatively characterize the time-course effects of CIS and CIM as single agents and combination in SA7K cells. Based on the experimental and modeling results, we selected relevant concentrations of CIS and CIM for our metabolomics study. With the help of PCA (Principal Component Analysis) and PLS-DA (Projection to Latent Structure - Discriminate Analysis) analyses, we confirmed global metabolome changes for different groups (CIS, CIM, CIS+CIM vs control) in SA7K cells. Based on the criterion of a p-value ≤ 0.05 and a fold change ≥ 2 or ≤ 0.5, we identified 20 top metabolites that were significantly changed during the early phase i.e. within first 12 h of CIS treatment. Finally, pathway analysis was conducted that revealed the key metabolic pathways that were most impacted in CIN.
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Affiliation(s)
- Hardik Mody
- Center for Pharmacometrics and Systems Pharmacology, Department of Pharmaceutics, College of Pharmacy, University of Florida, FL, USA
| | - Sreenath Nair
- Pharmaceutical Sciences Department, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Adrian Rump
- Center for Pharmacometrics and Systems Pharmacology, Department of Pharmaceutics, College of Pharmacy, University of Florida, FL, USA
| | - Tanaya R Vaidya
- Center for Pharmacometrics and Systems Pharmacology, Department of Pharmaceutics, College of Pharmacy, University of Florida, FL, USA
| | - Timothy J Garrett
- Southeast Center for Integrated Metabolomics, University of Florida, Gainesville, FL, USA
| | - Lawrence Lesko
- Center for Pharmacometrics and Systems Pharmacology, Department of Pharmaceutics, College of Pharmacy, University of Florida, FL, USA
| | - Sihem Ait-Oudhia
- Quantitative Pharmacology and Pharmacometrics (QP2), Merck & Co., Inc, Rahway, NJ, USA.
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Sun K, Wang B, Lin J, Han L, Li M, Wang P, Yu X, Tian J. A Multichannel Fluorescent Array Sensor for Discrimination of Different Types of Drug-Induced Kidney Injury. SENSORS (BASEL, SWITZERLAND) 2023; 23:6114. [PMID: 37447963 DOI: 10.3390/s23136114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 06/24/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023]
Abstract
The differences in urinary proteins could provide a novel opportunity to distinguish the different types of drug-induced kidney injury (DIKI). In this research, Au nanoparticles-polyethyleneimine (AuNPs-PEI) and the three fluorophore-labeled proteins (FLPs) have been constructed as a multichannel fluorescent array sensor via electrostatic interaction, which was used to detect the subtle changes in urine collected from the pathological state of DIKI. Once the urine from different types of DIKI was introduced, the binding equilibrium between AuNPs-PEI and FLPs would be broken due to the competitive binding of urinary protein, and the corresponding fluorescence response pattern would be generated. Depending on the different fluorescence response patterns, the different types of DIKI were successfully identified by principal component analysis (PCA) and linear discriminant analysis (LDA). Accordingly, the strategy was expected to be a powerful technique for evaluating the potential unclear mechanisms of nephrotoxic drugs, which would provide a promising method for screening potential renal-protective drugs.
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Affiliation(s)
- Kunhui Sun
- State Key Laboratory of Natural Medicines, Jiangsu Key Laboratory of TCM Evaluation and Translational Research, School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing 211198, China
- NMPA Key Laboratory for Bioequivalence Research of Generic Drug Evaluation, Shenzhen Institute for Drug Control, Shenzhen 518057, China
| | - Bing Wang
- NMPA Key Laboratory for Bioequivalence Research of Generic Drug Evaluation, Shenzhen Institute for Drug Control, Shenzhen 518057, China
| | - Jiaoli Lin
- State Key Laboratory of Natural Medicines, Jiangsu Key Laboratory of TCM Evaluation and Translational Research, School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing 211198, China
| | - Lei Han
- State Key Laboratory of Natural Medicines, Jiangsu Key Laboratory of TCM Evaluation and Translational Research, School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing 211198, China
| | - Meifang Li
- NMPA Key Laboratory for Bioequivalence Research of Generic Drug Evaluation, Shenzhen Institute for Drug Control, Shenzhen 518057, China
| | - Ping Wang
- NMPA Key Laboratory for Bioequivalence Research of Generic Drug Evaluation, Shenzhen Institute for Drug Control, Shenzhen 518057, China
| | - Xiean Yu
- NMPA Key Laboratory for Bioequivalence Research of Generic Drug Evaluation, Shenzhen Institute for Drug Control, Shenzhen 518057, China
| | - Jiangwei Tian
- State Key Laboratory of Natural Medicines, Jiangsu Key Laboratory of TCM Evaluation and Translational Research, School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing 211198, China
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Yu XA, Bai X, Zhang R, Zhang Y, Hu Y, Lu M, Yu BY, Liu S, Tian J. A nanosensor for precise discrimination of nephrotoxic drug mechanisms via dynamic fluorescence fingerprint strategy. Anal Chim Acta 2021; 1160:338447. [PMID: 33894967 DOI: 10.1016/j.aca.2021.338447] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/19/2021] [Accepted: 03/20/2021] [Indexed: 11/18/2022]
Abstract
Drug-induced kidney injury causes structural or functional abnormalities of kidney, seriously affecting clinical practice and drug discovery. However, rapid and effective identification of nephrotoxic drug mechanisms is yet a challenging task arising from the complexity and diversity of various nephrotoxic mechanisms. Herein, we have constructed a polydopamine-polyethyleneimine/quantum dots sensor to instantaneously read out the nephrotoxic drugs mechanisms based on the disparate cell surface phenotypes. Cell surface components induced by multiple nephrotoxic drugs can change the fluorescence emission of multicolor quantum dots, generating their corresponding fluorescent fingerprints. The fluorescence response signatures induced by different nephrotoxic agents are gained with 84% accuracy via linear discriminant analysis. Furthermore, taking the time-toxicity relationship into consideration, dynamic fluorescent fingerprint is obtained through continuous monitoring the progress of renal cell damage, achieving 100% precise classification for nephrotoxic mechanisms of four types of antibiotics. Notably, the fluorescent fingerprint-based high-throughput sensor has been demonstrated by successfully distinguishing nephrotoxic drugs in seconds, employing a promising protocol to discriminate the specific mechanism of nephrotoxic drugs, as well as drug safety evaluation.
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Affiliation(s)
- Xie-An Yu
- State Key Laboratory of Natural Medicines, Jiangsu Key Laboratory of TCM Evaluation and Translational Research, Research Center for Traceability and Standardization of TCMs, School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing, 211198, China; Shenzhen Institute for Drug Control, Shenzhen, 518057, China
| | - Xuefei Bai
- State Key Laboratory of Natural Medicines, Jiangsu Key Laboratory of TCM Evaluation and Translational Research, Research Center for Traceability and Standardization of TCMs, School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing, 211198, China
| | - Ran Zhang
- State Key Laboratory of Natural Medicines, Jiangsu Key Laboratory of TCM Evaluation and Translational Research, Research Center for Traceability and Standardization of TCMs, School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing, 211198, China
| | - Ying Zhang
- State Key Laboratory of Natural Medicines, Jiangsu Key Laboratory of TCM Evaluation and Translational Research, Research Center for Traceability and Standardization of TCMs, School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing, 211198, China
| | - Yiting Hu
- State Key Laboratory of Natural Medicines, Jiangsu Key Laboratory of TCM Evaluation and Translational Research, Research Center for Traceability and Standardization of TCMs, School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing, 211198, China
| | - Mi Lu
- State Key Laboratory of Natural Medicines, Jiangsu Key Laboratory of TCM Evaluation and Translational Research, Research Center for Traceability and Standardization of TCMs, School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing, 211198, China
| | - Bo-Yang Yu
- State Key Laboratory of Natural Medicines, Jiangsu Key Laboratory of TCM Evaluation and Translational Research, Research Center for Traceability and Standardization of TCMs, School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing, 211198, China.
| | - Shijia Liu
- Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210029, China.
| | - Jiangwei Tian
- State Key Laboratory of Natural Medicines, Jiangsu Key Laboratory of TCM Evaluation and Translational Research, Research Center for Traceability and Standardization of TCMs, School of Traditional Chinese Pharmacy, China Pharmaceutical University, Nanjing, 211198, China.
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Blair M, Côté JM, Cotter A, Lynch B, Redahan L, Murray PT. Nephrotoxicity from Vancomycin Combined with Piperacillin-Tazobactam: A Comprehensive Review. Am J Nephrol 2021; 52:85-97. [PMID: 33735856 DOI: 10.1159/000513742] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 12/11/2020] [Indexed: 12/13/2022]
Abstract
BACKGROUND Recent studies have identified the combination of vancomycin with piperacillin-tazobactam (VPT) to be associated with increased nephrotoxicity. Multiple, large cohort studies have found this widely used combination to have a higher risk of nephrotoxicity than other regimens in a variety of populations. SUMMARY This review summarizes the epidemiology and clinical features of VPT-associated acute kidney injury (AKI). Potential mechanisms involved in the pathogenesis of this phenomenon are also discussed. Key Message: VPT-associated nephrotoxicity is a recently recognized clinical entity. Clinical strategies to minimize the risk of toxicity in this setting include antimicrobial stewardship, monitoring of kidney function, and emerging data supporting the potential role for novel biomarkers in predicting and managing AKI.
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Affiliation(s)
- Matthew Blair
- Division of Medicine, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Jean-Maxime Côté
- Service of Nephrology, Department of Medicine, Centre Hospitalier Universitaire de Montréal, Montréal, Québec, Canada
- Clinical Research Centre, University College Dublin, Dublin, Ireland
| | - Aoife Cotter
- Department of Infectious Diseases, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Breda Lynch
- Department of Clinical Microbiology, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Lynn Redahan
- Division of Medicine, Mater Misericordiae University Hospital, Dublin, Ireland
- Department of Renal Medicine, Mater Misericordiae University Hospital, Dublin, Ireland
| | - Patrick T Murray
- Division of Medicine, Mater Misericordiae University Hospital, Dublin, Ireland,
- Clinical Research Centre, University College Dublin, Dublin, Ireland,
- Department of Renal Medicine, Mater Misericordiae University Hospital, Dublin, Ireland,
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Sramek JJ, Murphy MF, Adcock S, Stark JG, Cutler NR. Phase 1 Clinical Trials of Small Molecules: Evolution and State of the Art. Rev Recent Clin Trials 2021; 16:232-241. [PMID: 33563172 DOI: 10.2174/1574887116666210204125844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 12/24/2020] [Accepted: 01/13/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Phase 1 studies comprise the first exposure of a promising new chemical entity in healthy volunteers or, when appropriate, in patients. To assure a solid foundation for subsequent drug development, this first step must carefully assess the safety and tolerance of a new compound and often provide some indication of potential effect, so that a safe dose or dose range can be confidently selected for the initial Phase 2 efficacy study in the target patient population. METHODS This review was based on a literature search using both Google Scholar and PubMed, dated back to 1970, using search terms including "healthy volunteers", "Phase 1", and "normal volunteers", and also based on the authors' own experience conducting Phase 1 clinical trials. This paper reviews the history of Phase 1 studies of small molecules and their rapid evolution, focusing on the critical single and multiple dose studies, their designs, methodology, use of pharmacokinetic and pharmacodynamic modeling, application of potentially helpful biomarkers, study stopping criteria, and novel study designs. RESULTS We advocate for determining the safe dose range of a new compound by conducting careful dose escalation in a well-staffed inpatient setting, defining the maximally tolerated dose (MTD) by reaching the minimally intolerated dose (MID). The dose immediately below the MID is then defined as the MTD. This is best accomplished by using appropriately screened patients for the target indication, as patients in many CNS indications often tolerate doses differently than healthy non-patients. Biomarkers for safety and pharmacodynamic measures can also assist in further defining a safe and potentially effective dose range for subsequent clinical trial phases. CONCLUSION Phase 1 studies can yield critical insights into the pharmacology of a new compound in man and offer perhaps the only development period in which the dose range can be safely and thoroughly explored. Phase 1 studies often contain multiple endpoint objectives, the reconciliation of which can present a dilemma for drug developers and study investigators alike, but which can crucially determine whether a compound can survive to the next step in the drug development process.
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Affiliation(s)
- John J Sramek
- Worldwide Clinical Trials, 401 N Maple Dr, Beverly Hills, CA90210, United States
| | - Michael F Murphy
- Worldwide Clinical Trials, 480 E. Swedesford Rd, Suite 200, Wayne, PA19087, United States
| | - Sherilyn Adcock
- Worldwide Clinical Trials, San Antonio, TX78217, United States
| | - Jeffrey G Stark
- Worldwide Clinical Trials, 8609 Cross Park Dr, Austin, TX78754, United States
| | - Neal R Cutler
- Worldwide Clinical Trials, 401 N Maple Dr, Beverly Hills, CA90210, United States
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Mody H, Ramakrishnan V, Chaar M, Lezeau J, Rump A, Taha K, Lesko L, Ait-Oudhia S. A Review on Drug-Induced Nephrotoxicity: Pathophysiological Mechanisms, Drug Classes, Clinical Management, and Recent Advances in Mathematical Modeling and Simulation Approaches. Clin Pharmacol Drug Dev 2020; 9:896-909. [PMID: 33025766 DOI: 10.1002/cpdd.879] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Accepted: 09/08/2020] [Indexed: 12/13/2022]
Abstract
A variety of marketed drugs belonging to various therapeutic classes are known to cause nephrotoxicity. Nephrotoxicity can manifest itself in several forms depending on the specific site involved as well as the underlying pathophysiological mechanisms. As they often coexist with other pathophysiological conditions, the steps that can be taken to treat them are often limited. Thus, drug-induced nephrotoxicity remains a major clinical challenge. Prior knowledge of risk factors associated with special patient populations and specific classes of drugs, combined with early diagnosis, therapeutic drug monitoring with dose adjustments, as well as timely prospective treatments are essential to prevent and manage them better. Most incident drug-induced renal toxicity is reversible only if diagnosed at an early stage and treated promptly. Hence, diagnosis at an early stage is the need of the hour to counter it. Significant recent advances in the identification of novel early biomarkers of nephrotoxicity are not beyond limitations. In such a scenario, mathematical modeling and simulation (M&S) approaches may help to better understand and predict toxicities in a clinical setting. This review summarizes pathophysiological mechanisms of drug-induced nephrotoxicity, classes of nephrotoxic drugs, management, prevention, and diagnosis in clinics. Finally, it also highlights some of the recent advancements in mathematical M&S approaches that could be used to better understand and predict drug-induced nephrotoxicity.
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Affiliation(s)
- Hardik Mody
- Center for Pharmacometrics and Systems Pharmacology, Department of Pharmaceutics, College of Pharmacy, University of Florida, Gainesville, Florida, USA
| | - Vidya Ramakrishnan
- Department of Pharmaceutical Sciences, University at Buffalo, SUNY, Buffalo, New York, USA
| | - Maher Chaar
- Center for Pharmacometrics and Systems Pharmacology, Department of Pharmaceutics, College of Pharmacy, University of Florida, Gainesville, Florida, USA
| | - Jovin Lezeau
- Center for Pharmacometrics and Systems Pharmacology, Department of Pharmaceutics, College of Pharmacy, University of Florida, Gainesville, Florida, USA
| | - Adrian Rump
- Center for Pharmacometrics and Systems Pharmacology, Department of Pharmaceutics, College of Pharmacy, University of Florida, Gainesville, Florida, USA
| | - Kareem Taha
- Center for Pharmacometrics and Systems Pharmacology, Department of Pharmaceutics, College of Pharmacy, University of Florida, Gainesville, Florida, USA
| | - Lawrence Lesko
- Center for Pharmacometrics and Systems Pharmacology, Department of Pharmaceutics, College of Pharmacy, University of Florida, Gainesville, Florida, USA
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van Donge T, Welzel T, Atkinson A, van den Anker J, Pfister M. Age-Dependent Changes of Kidney Injury Biomarkers in Pediatrics. J Clin Pharmacol 2020; 59 Suppl 1:S21-S32. [PMID: 31502686 DOI: 10.1002/jcph.1487] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 06/21/2019] [Indexed: 12/12/2022]
Abstract
Currently used creatinine-based parameters for monitoring kidney function are not reliable for early detection of kidney injury (KI), particularly tubular damage. Several KI biomarkers allow for early detection of glomerular and tubular damage and may help to prevent drug-related chronic kidney diseases in pediatrics. This literature review describes the state of current research and investigates reference values for these KI biomarkers in neonates, infants, and children to better understand age-related changes. A total of 12 of 237 screened studies fulfilled predefined criteria, including 219 preterm neonates, 70 neonates, 596 infants, and 1726 children. KI biomarkers were analyzed in urine (6 studies), in serum/plasma (5 studies) and in serum and urine (1 study). Four studies (n = 555) measured urinary kidney injury molecule-1, whereas urinary neutrophil gelatinase-associated lipocalin was assessed in 5 studies (n = 888), and 2 studies (n = 203) investigated serum cystatin C. This review of KI biomarkers in different pediatric age groups indicates that (1) the majority of KI biomarkers are measured in urine; (2) the 3 most commonly analyzed KI biomarkers are urinary neutrophil gelatinase-associated lipocalin, urinary kidney injury molecule-1, and serum cystatin C; (3) values of KI biomarkers appear to decrease from prematurity to infancy; and (4) there is an unmet need to further enhance knowledge on age-dependent changes of KI biomarkers in pediatrics. Studies are needed to better characterize reference values for these key KI biomarkers in healthy pediatric populations and to evaluate the value of these markers in the early detection of drug-related KI in neonates, infants, and children.
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Affiliation(s)
- Tamara van Donge
- Pediatric Pharmacology and Pharmacometrics, University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland
| | - Tatjana Welzel
- Pediatric Pharmacology and Pharmacometrics, University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland
| | - Andrew Atkinson
- Pediatric Pharmacology and Pharmacometrics, University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland
| | - John van den Anker
- Pediatric Pharmacology and Pharmacometrics, University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland.,Division of Clinical Pharmacology, Children's National Health System, Washington, DC, USA.,Intensive Care and Department of Pediatric Surgery, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Marc Pfister
- Pediatric Pharmacology and Pharmacometrics, University Children's Hospital Basel (UKBB), University of Basel, Basel, Switzerland
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Bulacio RP, Torres AM. Caveolin-2 in urine as a novel biomarker of renal recovery after cisplatin induced nephrotoxicity in rats. Toxicol Lett 2019; 313:169-177. [DOI: 10.1016/j.toxlet.2019.07.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 07/01/2019] [Accepted: 07/04/2019] [Indexed: 02/05/2023]
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O'Donnell PH, Reynolds KS. Breaking Down Barriers to Effective Patient Care. Clin Pharmacol Ther 2019; 103:360-364. [PMID: 29417567 DOI: 10.1002/cpt.1026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 01/11/2018] [Indexed: 11/07/2022]
Abstract
The theme for the 2018 ASCPT Annual Meeting is "Breaking Down Barriers to Effective Patient Care." This theme refers to the essential contributions of clinical pharmacology to the development of today's discovery into tomorrow's medicine. The various subdisciplines within clinical pharmacology serve to move molecules through the various stages of drug development and also refine or expand use of the drug postapproval. The wide range of topics covered by the 2018 Annual Meeting scientific program demonstrates the breadth of clinical pharmacology's impact. Because of new methods being developed to identify drug targets, medicines are being developed for patients with rare diseases. Biomarkers and diagnostic tools are advancing the development of drugs for neurodegenerative disorders, cancer, and many other diseases. Preclinical data are playing a key role in informing the quantitative clinical pharmacology of drugs, especially antimicrobials, and animal efficacy data are pivotal for drugs that are developed and approved under the animal rule. The use of pharmacogenomics, model-based drug development, informatics, and identification and evaluation of subgroups are key topics. With our focus on the patient, the Annual Meeting, and this issue of Clinical Pharmacology & Therapeutics, will highlight the many innovative ways that current clinical pharmacology investigations are attempting to dissolve barriers to effective patient care.
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Affiliation(s)
- Peter H O'Donnell
- Department of Medicine, Center for Personalized Therapeutics, and Committee on Clinical Pharmacology and Pharmacogenomics, University of Chicago, Chicago, Illinois, USA
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