1. Translational High-Dimensional Drug Interaction Discovery and Validation Using Health Record Databases and Pharmacokinetics Models.
- Author
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Chiang CW, Zhang P, Wang X, Wang L, Zhang S, Ning X, Shen L, Quinney SK, and Li L
- Subjects
- Clonidine adverse effects, Clonidine pharmacokinetics, Cytochrome P-450 CYP2C19 Inhibitors administration & dosage, Cytochrome P-450 CYP2C19 Inhibitors pharmacokinetics, Cytochrome P-450 CYP3A Inhibitors administration & dosage, Cytochrome P-450 CYP3A Inhibitors pharmacokinetics, Databases, Factual, Drug Interactions, Evidence-Based Medicine methods, Fluconazole adverse effects, Fluconazole pharmacokinetics, Humans, Models, Biological, Muscular Diseases enzymology, Muscular Diseases epidemiology, Omeprazole adverse effects, Omeprazole pharmacokinetics, Patient Safety, Polypharmacy, Reproducibility of Results, Risk Assessment, United States epidemiology, Adverse Drug Reaction Reporting Systems, Cytochrome P-450 CYP2C19 Inhibitors adverse effects, Cytochrome P-450 CYP3A Inhibitors adverse effects, Data Mining methods, Drug Development methods, Drug Discovery methods, Electronic Health Records, Muscular Diseases chemically induced, Translational Research, Biomedical methods
- Abstract
Polypharmacy increases the risk of drug-drug interactions (DDIs). Combining epidemiological studies with pharmacokinetic modeling, we detected and evaluated high-dimensional DDIs among 30 frequent drugs. Multidrug combinations that increased the risk of myopathy were identified in the US Food and Drug Administration Adverse Event Reporting System (FAERS) and electronic medical record (EMR) databases by a mixture drug-count response model. CYP450 inhibition was estimated among the 30 drugs in the presence of 1 to 4 inhibitors using in vitro / in vivo extrapolation. Twenty-eight three-way and 43 four-way DDIs had significant myopathy risk in both databases and predicted increases in the area under the concentration-time curve ratio (AUCR) >2-fold. The high-dimensional DDI of omeprazole, fluconazole, and clonidine was associated with a 6.41-fold (FAERS) and 18.46-fold (EMR) increased risk of myopathy local false discovery rate (<0.005); the AUCR of omeprazole in this combination was 9.35. The combination of health record informatics and pharmacokinetic modeling is a powerful translational approach to detect high-dimensional DDIs., (© 2017 American Society for Clinical Pharmacology and Therapeutics.)
- Published
- 2018
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