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Complex Drug-Drug-Gene-Disease Interactions Involving Cytochromes P450: Systematic Review of Published Case Reports and Clinical Perspectives

Publié dansClinical Pharmacokinetics, vol. 57, no. 10, p. 1267-1293
Date de publication2018
Résumé

Drug pharmacokinetics (PK) is influenced by multiple intrinsic and extrinsic factors, among which concomitant medications are responsible for drug-drug interactions (DDIs) that may have a clinical relevance, resulting in adverse drug reactions or reduced efficacy. The addition of intrinsic factors affecting cytochromes P450 (CYPs) activity and/or expression, such as genetic polymorphisms and diseases, may potentiate the impact and clinical relevance of DDIs. In addition, greater variability in drug levels and exposures has been observed when such intrinsic factors are present in addition to concomitant medications perpetrating DDIs. This variability results in poor predictability of DDIs and potentially dramatic clinical consequences. The present review illustrates the issue of complex DDIs using systematically searched published case reports of DDIs involving genetic polymorphisms, renal impairment, cirrhosis, and/or inflammation. Current knowledge on the impact of each of these factors on drug exposure and DDIs is summarized and future perspectives for the management of such complex DDIs in clinical practice are discussed, including the use of advanced Computerized Physician Order Entry (CPOE) systems, the development of model-based dose optimization strategies, and the education of healthcare professionals with respect to personalized medicine.

Citation (format ISO)
STORELLI, Flavia et al. Complex Drug-Drug-Gene-Disease Interactions Involving Cytochromes P450: Systematic Review of Published Case Reports and Clinical Perspectives. In: Clinical Pharmacokinetics, 2018, vol. 57, n° 10, p. 1267–1293. doi: 10.1007/s40262-018-0650-9
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ISSN du journal0312-5963
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Informations techniques

Création13.11.2018 15:11:00
Première validation13.11.2018 15:11:00
Heure de mise à jour15.03.2023 13:14:22
Changement de statut15.03.2023 13:14:22
Dernière indexation17.01.2024 04:07:49
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