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Cocco M, Carnovale C, Clementi E, Barbieri MA, Battini V, Sessa M. Exploring the impact of co-exposure timing on drug-drug interactions in signal detection through spontaneous reporting system databases: a scoping review. Expert Rev Clin Pharmacol 2024; 17:441-453. [PMID: 38619027 DOI: 10.1080/17512433.2024.2343875] [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: 12/22/2023] [Accepted: 04/12/2024] [Indexed: 04/16/2024]
Abstract
INTRODUCTION Drug-drug interactions (DDIs) are defined as the pharmacological effects produced by the concomitant administration of two or more drugs. To minimize false positive signals and ensure their validity when analyzing Spontaneous Reporting System (SRS) databases, it has been suggested to incorporate key pharmacological principles, such as temporal plausibility. AREAS COVERED The scoping review of the literature was completed using MEDLINE from inception to March 2023. Included studies had to provide detailed methods for identifying DDIs in SRS databases. Any methodological approach and adverse event were accepted. Descriptive analyzes were excluded as we focused on automatic signal detection methods. The result is an overview of all the available methods for DDI signal detection in SRS databases, with a specific focus on the evaluation of the co-exposure time of the interacting drugs. It is worth noting that only a limited number of studies (n = 3) have attempted to address the issue of overlapping drug administration times. EXPERT OPINION Current guidelines for signal validation focus on factors like the number of reports and temporal association, but they lack guidance on addressing overlapping drug administration times, highlighting a need for further research and method development.
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Affiliation(s)
- Marianna Cocco
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
- Department of Drug Sciences, University of Pavia, Pavia, Italy
| | - Carla Carnovale
- Pharmacovigilance & Clinical Research, International Centre for Pesticides and Health Risk Prevention, Department of Biomedical and Clinical Sciences (DIBIC), ASST Fatebenefratelli-Sacco University Hospital, Università Degli Studi di Milano, Milan, Italy
| | - Emilio Clementi
- Pharmacovigilance & Clinical Research, International Centre for Pesticides and Health Risk Prevention, Department of Biomedical and Clinical Sciences (DIBIC), ASST Fatebenefratelli-Sacco University Hospital, Università Degli Studi di Milano, Milan, Italy
- Scientific Institute, IRCCS E. Medea, Bosisio Parini, LC, Italy
| | - Maria Antonietta Barbieri
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Vera Battini
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - Maurizio Sessa
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
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Heck KL, Walters LM, Kunze ML, Calderón AI. Standardization of açaí extracts for in-vitro assays based on anthocyanin quantitation. J Food Compost Anal 2023; 118:105155. [PMID: 36844472 PMCID: PMC9957365 DOI: 10.1016/j.jfca.2023.105155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Euterpe oleracea Mart., commonly known as açaí, is a fruit that grows on a palm tree native to the Amazon region. Quantitation of bioactive constituents is a crucial preliminary step before utilizing extracts for biological assays so they may be normalized and administered according to a specific constituent concentration. Açaí has four main anthocyanin analytes: cyanidin 3-glucoside, cyanidin 3-sambubioside, cyanidin 3-rutinoside, and peonidin 3-rutinoside. This is the first comparison of açaí anthocyanin profiles between fresh fruits, processed powders, and botanical dietary supplement capsules. The materials examined shared a similar anthocyanin profile, with cyanidin 3-rutinoside being the most abundant (0.380 ± 0.006 - 15.1 ± 0.01 mg/g), followed by cyanidin 3-glucoside (0.0988 ± 0.0031 - 8.95 ± 0.01 mg/g). Among the botanical dietary supplement capsules, the two formulations varied greatly in anthocyanin concentration despite both being aqueous extracts (0.650 ± 0.011 - 0.924 ± 0.010 mg/g versus 1.23 ± 0.01 - 1.27 ± 0.02 mg/g). Previous LC-MS methods range from 35-120 min per injection, while we report a 10 min quantitative method for analysis of anthocyanins in various açaí materials that is fast, reproducible, and accurate. The method produced is useful to assure the quality, efficacy and safety of food and dietary supplement materials containing açaí.
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Affiliation(s)
- Kabre L. Heck
- Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, Auburn AL 36849, United States
| | - Lauren M. Walters
- Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, Auburn AL 36849, United States
| | - Madeline L. Kunze
- Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, Auburn AL 36849, United States
| | - Angela I. Calderón
- Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, Auburn AL 36849, United States
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Bazrafshani MS, Pardakhty A, Kalantari Khandani B, Tajadini H, Ghazanfari Pour S, Hashemi S, Amiri S, Mehmandoost S, Beigzadeh A, Abbaszadeh S, Sharifi H. The prevalence and predictors of herb-drug interactions among Iranian cancer patients during chemotherapy courses. BMC Complement Med Ther 2023; 23:41. [PMID: 36750849 PMCID: PMC9903537 DOI: 10.1186/s12906-023-03869-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 01/31/2023] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND The concurrent usage of herbal medicines with conventional therapies is an important concern in cancer treatment which can lead to unexpected consequences like herb-drug interactions. This study aimed to determine the prevalence of potential herb-drug interactions and to predict factors associated with herb-drug interactions for cancer patients. METHODS This cross-sectional study was conducted among a convenience sample of 315 cancer patients referring to the oncology clinics of Kerman city in 2018. Data were collected via comprehensive face-to-face interviews and medical chart reviews. A drug interaction checker was used to determine herb-drug interactions. The information of patients was compared based on herb-drug interactions using bivariable logistic regression models, and predictors were determined by the multivariable logistic regression model. All analyses were performed by Stata software version 16. RESULTS Of 262 patients (83.2% of the patients) who used herbal medicines, 209 patients [79.8% (95% Confidence Intervals (CI): 75.2 - 85.1)] had potential herb-drug interactions. Chamomile was the most popular herbal medicine (n = 163, 78.0%), and minor and moderate herb-drug interactions were caused by green tea (n = 34, 16.3%) and peppermint (n = 78, 37.5%). The number of chemotherapeutic agents (OR: 1.92, 95% CI: 1.43-2.58; P-value < 0.0001) and the experienced of pain during chemotherapy courses (OR = 2.22, 95%CI:1.00-4.94; P-value = 0.04) were some of the predictors of herb-drug interactions among cancer patients. CONCLUSION Herbal medicine use during chemotherapy was found prevalent among cancer patients; of them, the experience of potential herb-drug interactions was highly frequent. Oncologists and clinical pharmacologists are recommended to take into account challenges associated with herb-drug interactions in their routine practices, particularly during chemotherapy among these patients.
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Affiliation(s)
- Maliheh Sadat Bazrafshani
- grid.412105.30000 0001 2092 9755HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, 7616914111 Iran
| | - Abbas Pardakhty
- Pharmaceutics Research Center, Neuropharmacology Institute, Kerman University of Medical Sciences, Kerman, Iran.
| | - Behjat Kalantari Khandani
- grid.412105.30000 0001 2092 9755Department of Internal Medicine, Hematology and Oncology Division, Kerman University of Medical Sciences, Kerman, Iran
| | - Haleh Tajadini
- grid.412105.30000 0001 2092 9755Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Sadra Ghazanfari Pour
- grid.412105.30000 0001 2092 9755Student Research Committee, Kerman University of Medical Sciences, Kerman, Iran
| | - Sara Hashemi
- grid.412105.30000 0001 2092 9755Departement of Medical Chemistry, Faculty of Pharmacy, Kerman University of Medical Sciences, Kerman, Iran
| | - Shiva Amiri
- grid.412105.30000 0001 2092 9755Pharmaceutics Research Center, Neuropharmacology Institute, Kerman University of Medical Sciences, Kerman, Iran ,grid.412105.30000 0001 2092 9755Department of Toxicology and Pharmacology, Faculty of Pharmacy, Kerman University of Medical Sciences, Kerman, Iran
| | - Soheil Mehmandoost
- grid.412105.30000 0001 2092 9755HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, 7616914111 Iran
| | | | - Samaneh Abbaszadeh
- grid.412105.30000 0001 2092 9755HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, 7616914111 Iran
| | - Hamid Sharifi
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, 7616914111, Iran.
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Lam CS, Koon HK, Ma CT, Au KY, Zuo Z, Chung VCH, Cheung YT. Real-world data on herb-drug interactions in oncology: A scoping review of pharmacoepidemiological studies. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2022; 103:154247. [PMID: 35716539 DOI: 10.1016/j.phymed.2022.154247] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 05/14/2022] [Accepted: 06/05/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND The concurrent use of conventional drugs and herbal medicines is becoming popular among patients with cancer. However, the potential risk of herb-drug interactions (HDI) remains under-addressed in the literature. Previous reviews have mainly focused on the prevalence of interactions, with less attention paid to the methods used by pharmacoepidemiological studies on evaluating HDI. This scoping review aims to summarize the existing pharmacoepidemiological studies that evaluate HDI using real-world data and to identify gaps to be addressed in future research. METHODS A comprehensive search was performed in nine English- and Chinese-language databases from their inception to May 2021. Gray literature and manual searches were conducted to identify additional studies. The recommended components of the pharmacoepidemiological studies and key findings related to HDI were summarized. The proportion (%) of patients with cancer at risk of HDI was estimated by combining data from eligible studies. RESULTS Twenty-eight studies were included in the review. More than half of these studies were cross-sectional studies (n = 18, 64.3%), followed by retrospective cohort studies (n = 5, 17.9%) and prospective cohort studies (n = 2, 7.1%). The three cancer drugs most commonly studied for their interaction potential with herbs were tamoxifen (n = 11, 39.3%), cyclophosphamide (n = 6, 21.4%), and paclitaxel (n = 6, 21.4%). Most cross-sectional studies identified potential HDI using tertiary databases and primary literature searches. Conversely, prospective and retrospective studies mainly investigated actual clinical outcomes, such as adverse events and secondary cancer occurrences. Most interaction outcomes identified using real-world data did not lead to negative clinical consequences. Collectively, 45.4% of herbal medicine users of the included studies were found to be at risk of HDI. We infer from this review that the common limitations of these studies were limited sample size, lack of data on herbal medicine use and details of HDI, and lack of evidence of HDI. Based on the study limitations, several recommendations to enrich the data sources and optimize the study designs were proposed. CONCLUSIONS There is a high demand for pharmacoepidemiological research on HDI, considering the increasing popularity of herbal medicine among patients with cancer. It is anticipated that emerging real-world data in this field can guide the development of safe and effective approaches to integrative oncology.
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Affiliation(s)
- Chun Sing Lam
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, 8th Floor, Lo Kwee-Seong Integrated Biomedical Sciences Building, Area 39, Shatin, NT, Hong Kong
| | - Ho Kee Koon
- School of Chinese Medicine, Faculty of Medicine, Chung Chi College, The Chinese University of Hong Kong, Room 101, Li Wai Chun Building, Shatin, NT, Hong Kong
| | - Chung Tin Ma
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, 8th Floor, Lo Kwee-Seong Integrated Biomedical Sciences Building, Area 39, Shatin, NT, Hong Kong
| | - Kwok Yin Au
- Hong Kong Institute of Integrative Medicine, The Chinese University of Hong Kong, Prince of Wales Hospital, 4L, 4/F, Day Treatment Block, Shatin, NT, Hong Kong
| | - Zhong Zuo
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, 8th Floor, Lo Kwee-Seong Integrated Biomedical Sciences Building, Area 39, Shatin, NT, Hong Kong
| | - Vincent Chi-Ho Chung
- School of Chinese Medicine, Faculty of Medicine, Chung Chi College, The Chinese University of Hong Kong, Room 101, Li Wai Chun Building, Shatin, NT, Hong Kong; Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Prince of Wales Hospital, Room 202, School of Public Health Building, Shatin, NT, Hong Kong
| | - Yin Ting Cheung
- School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, 8th Floor, Lo Kwee-Seong Integrated Biomedical Sciences Building, Area 39, Shatin, NT, Hong Kong.
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Garrett B, Caulfield T, Murdoch B, Brignall M, Kapur AK, Murphy S, Nelson E, Reardon J, Harrison M, Hislop J, Wilson‐Keates BJ, Anthony J, Loewen PS, Musoke RM, Braun J. A taxonomy of risk-associated alternative health practices: A Delphi study. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:1163-1181. [PMID: 34041822 PMCID: PMC9291966 DOI: 10.1111/hsc.13386] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 02/23/2021] [Accepted: 03/08/2021] [Indexed: 06/12/2023]
Abstract
Defining alternative health care and the recording of associated adverse events and harm remains problematic. This Canadian study aimed to establish and classify risk-associated alternative health practices in a Delphi study undertaken with an interdisciplinary panel of 17 health experts in 2020. It provides a new functional definition of alternative health care and an initial taxonomy of risk-associated alternative health care practices. A number of risk-associated practices were identified and categorized into general practices that conflict with biomedical care or largely untested therapies, alternative beliefs systems, physical manipulative alternative therapies, and herbal and nutritional supplements. Some risk significant harms including major physical injuries or even death. The lack of systematic methods for recording adverse events in alternative health care makes establishing the frequency of such events challenging. However, it is important that people engaging with alternative health care understand they are not necessarily risk-free endeavours, and what those risks are.
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Affiliation(s)
- Bernie Garrett
- School of NursingUniversity of British ColumbiaVancouverBCCanada
| | - Timothy Caulfield
- Faculty of LawHealth Law InstituteUniversity of AlbertaEdmontonABCanada
| | - Blake Murdoch
- Faculty of LawHealth Law InstituteUniversity of AlbertaEdmontonABCanada
| | | | | | - Susan Murphy
- Department of Physical TherapyFaculty of MedicineUniversity of British ColumbiaVancouverBCCanada
| | - Erin Nelson
- Faculty of LawHealth Law InstituteUniversity of AlbertaEdmontonABCanada
| | - Jillian Reardon
- Faculty of Pharmaceutical SciencesUniversity of British ColumbiaVancouverBCCanada
| | - Mark Harrison
- Faculty of Pharmaceutical SciencesUniversity of British ColumbiaVancouverBCCanada
- Centre for Health Evaluation and Outcome Sciences (CHEOS)St. Paul’s HospitalVancouverBCCanada
| | - Jonathan Hislop
- Family MedicineUniversity of British ColumbiaVancouverBCCanada
| | | | - Joseph Anthony
- Department of Physical TherapyFaculty of MedicineUniversity of British ColumbiaVancouverBCCanada
| | - Peter S. Loewen
- Faculty of Pharmaceutical SciencesUniversity of British ColumbiaVancouverBCCanada
| | - Richard M. Musoke
- School of Population and Public HealthUniversity of British ColumbiaVancouverBCCanada
| | - Joan Braun
- Bora Laskin Faculty of LawLakehead UniversityThunder BayONCanada
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