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Clinical Importance of Drug-Drug Interactions

药物相互作用的临床重要性

基本信息

批准号：
8297149
负责人：
Sean Hennessy
金额：
$ 61.69万
依托单位：
UNIVERSITY OF PENNSYLVANIA
依托单位国家：
美国
项目类别：
财政年份：
2006
资助国家：
美国
起止时间：
2006-09-15 至 2017-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8297149
关键词：
Address Affect Age Agreement Anticoagulation Antidiabetic Drugs Appearance Attenuated Award Biological Characteristics Clinical Coagulation Process Collaborations Cytochrome P450 Data Data Set Databases Development Drug Interactions Drug Kinetics Elderly Esomeprazole Event Fenofibrate Fibrates Frequencies Future Gemfibrozil Glipizide Glyburide Goals Grant Hemorrhage Hypoglycemia Impact evaluation In Vitro Indiana International Normalized Ratio Ischemic Stroke Knowledge Lansoprazole Lipids Lovastatin Marketing Measures Medicare/Medicaid Metabolism Monitor Omeprazole Oral Outcome P-Glycoprotein Patients Pharmaceutical Preparations Pioglitazone Polypharmacy Population Population Database Population Study Pravastatin Process Proton Pump Inhibitors Public Health Recommendation Research Risk Science Series Serum Simvastatin Source Structure Sulfonylurea Compounds Thromboembolism Time Uncertainty Universities Update Venous Warfarin atorvastatin base clinical effect clopidogrel computerized diabetic fluvastatin gastrointestinal glucose monitor human CYP2C9 protein in vivo indexing innovation interdisciplinary collaboration interest medical schools population based programs risk mitigation rosuvastatin symposium tool

项目摘要

DESCRIPTION (provided by applicant): Drug-drug interactions (DDIs) are a significant clinical and public health burden, especially for older adults. This burden will increase further as the population ages and the degree of polypharmacy increases. Knowledge about DDIs comes from many sources, with rigorous population-based studies of clinical outcomes providing the most clinically useful information. Because very few population DDI studies have been performed, there is profound disagreement among the DDI compendia about which drug pairs cause clinically important DDIs. Further, uncertainty about which potential DDIs are clinically important has hampered efforts to mitigate the effects of DDIs, such as computerized decision support. Population studies of the clinical effects of DDIs are therefore badly needed, and should be integrated with research on the biological basis of DDIs. In this renewal application, we propose to extend our approach to population DDI studies in two important and innovative ways: 1) by actively and explicitly incorporating mechanistic considerations; and 2) by implementing a sequential approach of initially identifying and quantifying risk, then, where warranted based on this step, characterizing important DDIs further, with the goal of providing the basis for future efforts to mitigate risk. Based on an extensive and structured consultative process to identify research foci, we propose to conduct a series of population DDI studies using a large 5-state Medicaid/Medicare dataset. These studies will examine hypothesized interactions involving lipid lowering drugs, anti-clotting drugs, and oral anti-diabetic drugs, three drug classes with enormous relevance for older adults, and with high potential for causing clinically important DDIs. Thus, we will study potential DDIs of great clinical and public health importance, especially to older adults, and in the process develop data that will help elucidate the mechanisms of these potential DDIs. PUBLIC HEALTH RELEVANCE: Drug-drug interactions (DDIs) are a significant clinical and public health burden, especially for older adults. However, little is known about the clinical importance of most potential DDIs. We will conduct large population studies of the clinical importance of potential DDIs affecting lipid lowering, anti-clotting, and anti-diabetic therapies, addressing potential DDIs of great clinical and public health importance.

描述（由申请人提供）：药物-药物相互作用（ddi）是一个重要的临床和公共卫生负担，特别是对老年人。随着人口老龄化和多种药物使用程度的增加，这一负担将进一步增加。关于ddi的知识来自许多来源，严格的基于人群的临床结果研究提供了最具临床价值的信息。由于很少进行人群DDI研究，DDI纲要中对于哪些药物对引起临床重要的DDI存在深刻的分歧。此外，不确定哪些潜在的ddi在临床上是重要的