Presented virtually at ASCPT Annual Meeting, March 2021
Lindsay M. Henderson, Claire Steinbronn, Jingjing Yu, Cathy Yeung, and Isabelle Ragueneau-Majlessi
This study’s objective was to evaluate the consistency in DDI labeling language of recently marketed drugs (2012-2020) when found to alter the exposure of coadministered digoxin, a clinical P-glycoprotein (P-gp) substrate and narrow therapeutic index (NTI) medication.
We have recorded a one-hour long video tutorial suitable as a refresher training or to kick-start the use of DIDB. It starts by introducing the different lists available in the Resource Center of DIDB and then, it shows how to retrieve the human in vitro metabolism and transport information using preformulated queries. Finally it presents the in vivo datasets and how to retrieve clinical PK-based information from drug-drug interaction, food-effect, organ impairment and pharmacogenetics studies.
The video is available in DIDB Resource Center. Please note that you must be signed in to access.
We are pleased to provide access to an innovative online tool: DDPred, developed by the University of Lyon, France, that uses an in vivo static mechanistic model to predict PK-based DDIs with hundreds of substrates and inhibitors/inducers and evaluates the impact of polymorphism.
The link to this application will be available to all DIDB users during a 6-month evaluation. Please take the time to test it and to provide your feedback in the online survey. We value your feedback! Thank you.
DIDB has been updated with the following new features:
Feel free to contact us if you experience any issues or if you have any questions or suggestions. Your feedback is always greatly valued!
The draft guidance newly released by FDA on “Evaluation go Gastric pH-Dependent Drug Interactions with Acid-Reducing Agents: Study Design, Data Analysis, and Clinical Implications” is now available in DIDB Resource Center. Please note that you must be signed in to access.
This draft guidance describes FDA’s recommendations regarding: (1) when clinical DDI studies with acid-reducing agents are needed; (2) the design of clinical DDI studies; (3) how to interpret study results; and (4) communicating findings in product labeling.
DIDB contains absorption-based drug interaction data. The study results are presented based on the underlying mechanism. For example, there are about 450 entries on pH-dependent drugs interactions in DIDB curated from literature and NDA reviews with detailed information about PK assessment results, study design, population, formulation, dosing, and safety results
DIDB has been updated with the following new features:
Feel free to contact us if you experience any issues or if you have any questions or suggestions. Your feedback is always greatly valued!
The draft guidance newly released by FDA on “Clinical Drug Interaction Studies Combined with Oral Contraceptives” is now available in DIDB Resource Center. Please note that you must be signed in to access.
This draft guidance focuses on evaluating the DDI potential of an investigational new drug (i.e., perpetrator) on combined oral contraceptives (COCs; i.e., victim) during drug development and determining how to communicate DDI study results and mitigation strategies to address potential risks associated with increased or decreased exposure of COCs in labeling.
In DIDB (as of Nov 2020), there are over 600 entries evaluating COCs as an object in dedicated clinical PK studies (including PGx data). On the other hand, nearly 200 entries were curated from clinical DDI studies where COCs serve as a precipitant.
The guidance newly released by FDA on “Pharmacokinetics in Patients with Impaired Renal Function — Study Design, Data Analysis, and Impact on Dosing and Labeling” is now available in DIDB Resource Center. Please note that you must be signed in to access.
For your information, DIDB contains study results from organ impairment studies following the recommendations in the FDA guidances on impaired renal function and on impaired hepatic function. As such study design, population, degree of organ impairment, drug dosing, PK, PD, and safety results are extracted from the literature and NDAs/BLAs reviews and entered in DIDB.
The draft guidance newly released by FDA on “Drug-Drug Interaction Assessment of Therapeutics Proteins” is now available in DIDB Resource Center. Please note that you must be signed in to access.
For your information, in addition to small molecules, DIDB also contains drug-drug interaction data for therapeutic proteins extracted from literature and FDA biological license applications (BLAs).
New drug application reviews contain critical drug interaction study results with newly approved drugs tested both as victims and as perpetrators of drug-drug interactions (DDIs). Pharmacokinetic-based DDI data for drugs approved by the US Food and Drug Administration in 2013–2017 (N = 137) were analyzed using the University of Washington Drug Interaction Database. For the largest metabolism- and transporter-based drug interactions, defined as a change in exposure ≥ 5-fold in victim drugs, the mechanisms and clinical relevance were characterized. Consistent with the major role of CYP3A in drug disposition, CYP3A inhibition and induction explained a majority of the observed interactions (new drugs as victims or as perpetrators). However, transporter-mediated interactions were also prevalent, with OATP1B1/1B3 playing a significant role. As victims, 17 and 4 new molecular entities (NMEs) were identified to be sensitive substrates of enzymes and transporters, respectively. When considered as perpetrators, three drugs showed strong inhibition of CYP3A, one was a strong CYP3A inducer, and two showed strong inhibition of transporters (OATP1B1/1B3 and/or BCRP). All DDIs with AUC changes ≥ 5-fold had labeling recommendations in their respective drug labels, contraindicating or limiting the coadministration with known substrates or perpetrators of the enzyme/transporter involved. The majority of sensitive substrates or strong inhibitors were oncology and antiviral treatments, suggesting a significant risk of DDIs in these patient populations for whom therapeutic management is already complex due to poly-therapy. Pharmacogenetic studies and physiologically based pharmacokinetic models were commonly used to assess the drug interaction potential in specific populations and clinical scenarios. Finally, absorption-based DDIs were evaluated in approximately 30% of drug applications, and 14 NMEs had label recommendations based on the results.