Evidence map›Paper›PMID 35484780›Full record

SynthesisBritish journal of clinical pharmacology2022

A systematic review on disease-drug-drug interactions with immunomodulating drugs: A critical appraisal of risk assessment and drug labelling.

Laura M de Jong, Sylvia D Klomp, Nicoline Treijtel, Robert Rissmann, Jesse J Swen, Martijn L Manson

Open access · bronzeAbstract readSystematic Review
In one paragraph

Synthesis in British journal of clinical pharmacology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.5field-weighted citation impact, top 40% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 2 countries.

Laura M de JongDivision of System Pharmacology and Pharmacy, Leiden Academic Centre for Drug Research, Leiden University, the Netherlands.ORCID 0000-0001-9719-6051
Sylvia D KlompDepartment of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, the Netherlands.ORCID 0000-0001-8124-5293
Nicoline TreijtelCentre for Human Drug Research, Leiden, the Netherlands.
Robert RissmannDivision of BioTherapeutics, Leiden Academic Centre for Drug Research, Leiden University, the Netherlands.ORCID 0000-0002-5867-9090
Jesse J SwenDepartment of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, the Netherlands.ORCID 0000-0002-3965-5552
Martijn L MansonDivision of System Pharmacology and Pharmacy, Leiden Academic Centre for Drug Research, Leiden University, the Netherlands.ORCID 0000-0002-5508-8615
Leiden University · NLLeiden University Medical Center · NLCentre for Human Drug Research · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimUse of immunomodulating therapeutics for immune-mediated inflammatory diseases may cause disease-drug-drug interactions (DDDIs) by reversing inflammation-driven alterations in the metabolic capacity of cytochrome P450 enzymes. European Medicine Agency (EMA) and US Food and Drug Administration (FDA) guidelines from 2007 recommend that the DDDI potential of therapeutic proteins should be assessed. This systematic analysis aimed to characterize the available DDDI trials with immunomodulatory drugs, experimental evidence for a DDDI risk and reported DDDI risk information in FDA/EMA approved drug labelling.

methodFor this systematic review, the EMA list of European Public Assessment Reports of human medicine was used to select immunomodulating monoclonal antibodies (mAbs) and tyrosine kinase inhibitors (TKIs) marketed after 2007 at risk for a DDDI. Selected drugs were included in PubMed and Embase searches to extract reported interaction studies. The Summary of Product Characteristics (SPCs) and the United States Prescribing Information (USPIs) were subsequently used for analysis of DDDI risk descriptions.

resultsClinical interaction studies to evaluate DDDI risks were performed for 12 of the 24 mAbs (50%) and for none of the TKIs. Four studies identified a DDDI risk, of which three were studies with interleukin-6 (IL-6) neutralizing mAbs. Based on (non)clinical data, a DDDI risk was reported in 32% of the SPCs and in 60% of the USPIs. The EMA/FDA documentation aligned with the DDDI risk potential in 35% of the 20 cases.

conclusionThis systematic review reinforces that the risk for DDDI by immunomodulating drugs is target- and disease-specific. Drug labelling information designates the greatest DDDI risk to mAbs that neutralize the effects of IL-6, Tumor Necrosis Factor alfa (TNF-α) and interleukin-1 bèta (IL-1β) in diseases with systemic inflammation.

Indexed as

Drug LabelingImmunomodulating AgentsAntibodies, MonoclonalDrug ApprovalDrug InteractionsHumansInflammationInterleukin-1betaInterleukin-6Pharmaceutical PreparationsProtein Kinase InhibitorsRisk AssessmentTumor Necrosis Factor-alphaUnited StatesUnited States Food and Drug AdministrationAntibodies, MonoclonalImmunomodulating AgentsInterleukin-1betaInterleukin-6Pharmaceutical PreparationsProtein Kinase InhibitorsTumor Necrosis Factor-alphacytochrome P450 enzymes (CYP)cytokinesdisease-drug-drug interactionsdrug-drug interactionsdrug labellingEMAFDAimmunomodulationinflammationmonoclonal antibodyphenoconversionSPCtherapeutic proteinstyrosine kinase inhibitorUSPI

Identifiers

PMID35484780
PMCPMC9545038
OpenAlexW4225083974

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.