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- Title
Potentials and limitations of nonclinical safety assessment for predicting clinical adverse drug reactions: correlation analysis of 142 approved drugs in Japan.
- Authors
Chihiro Tamaki; Takashi Nagayama; Masamichi Hashiba; Masato Fujiyoshi; Masanori Hizue; Hiroshi Kodaira; Minoru Nishida; Kazuhiko Suzuki; Yoshiharu Takashima; Yamato Ogino; Daisaku Yasugi; Yasuo Yoneta; Shigeru Hisada; Takako Ohkura; Kazuichi Nakamura
- Abstract
The objective of this study was to elucidate the range of abilities of nonclinical safety assessment for predicting adverse drug reactions (ADRs) in humans. The dataset included 1256 ADRs with an incidence rate of 5% or more collected from 142 drugs approved in Japan from 2001 to 2010 (excluding anticancer agents and vaccines). Gastrointestinal, neurological and hepatobiliary ADRs were relatively common, followed by hematological, cutaneous, systemic and cardiovascular ADRs in the data-set. The analysis revealed that 48% of ADRs were predictable based on a comprehensive nonclinical safety assessment considering animal toxicity. Hematological and ocular ADRs, infection, and application site reactions showed a correlation of more than 70%, while musculoskeletal, respiratory and neurological ADRs showed a correlation of less than 30%. In addition to subjective patient perceptions, several laboratory parameters routinely monitored both in animals and humans showed a lower correlation, e.g., abnormalities in hepatobiliary and metabolic parameters, and blood pressure increase. Large molecule drugs showed lower correlation than small molecule drugs; ADRs were observed in various organs and consideration of pharmacological action did not significantly contribute to the prediction. It was also confirmed that the current standard of toxicology testing regarding dosing duration and dose level is adequate to biodetect concordant animal toxicity. This study collectively demonstrated a significant value of nonclinical safety assessment in predicting ADRs in humans. It also identified the subset of ADRs with poor predictability, highlighting the need for advanced testing that enables successful translation of animal toxicity to clinical settings with better accuracy and sensitivity.
- Subjects
DRUG side effects; GASTROINTESTINAL agents; STATISTICAL correlation; HEMATOLOGIC agents; TOXICITY testing; PHARMACEUTICAL research; BLOOD pressure
- Publication
Journal of Toxicological Sciences, 2013, Vol 38, Issue 4, p581
- ISSN
0388-1350
- Publication type
Article
- DOI
10.2131/jts.38.581