Biostatistics & Programming, Sanofi K.K, Shinjuku-ku, Tokyo, Japan.
Department of Biostatistics, Institute of Medicine, University of Tsukuba, Tsukuba-shi, Ibaraki, Japan.
Stat Med. 2024 Aug 15;43(18):3353-3363. doi: 10.1002/sim.10137. Epub 2024 Jun 5.
Due to the insufficiency of safety assessments of clinical trials for drugs, further assessments are required for post-marketed drugs. In addition to adverse drug reactions (ADRs) induced by one drug, drug-drug interaction (DDI)-induced ADR should also be investigated. The spontaneous reporting system (SRS) is a powerful tool for evaluating the safety of drugs continually. In this study, we propose a novel Bayesian method for detecting potential DDIs in a database collected by the SRS. By applying a power prior, the proposed method can borrow information from similar drugs for a drug assessed DDI to increase sensitivity of detection. The proposed method can also adjust the amount of the information borrowed by tuning the parameters in power prior. In the simulation study, we demonstrate the aforementioned increase in sensitivity. Depending on the scenarios, approximately 20 points of sensitivity of the proposed method increase from an existing method to a maximum. We also indicate the possibility of early detection of potential DDIs by the proposed method through analysis of the database shared by the Food and Drug Administration. In conclusion, the proposed method has a higher sensitivity and a novel criterion to detect potential DDIs early, provided similar drugs have similar observed-expected ratios to the drug under assessment.
由于药物临床试验的安全性评估不足,需要对上市后的药物进行进一步评估。除了药物不良反应(ADR)外,还应研究药物-药物相互作用(DDI)引起的 ADR。自发报告系统(SRS)是不断评估药物安全性的有力工具。在这项研究中,我们提出了一种新的贝叶斯方法,用于检测 SRS 收集的数据库中的潜在 DDI。通过应用功效先验,所提出的方法可以从评估 DDI 的药物的类似药物中借用信息,以提高检测的灵敏度。该方法还可以通过调整功效先验中的参数来调整借用的信息量。在模拟研究中,我们证明了上述灵敏度的提高。根据不同的情况,与现有方法相比,所提出方法的灵敏度大约提高了 20 个点。我们还通过分析食品和药物管理局共享的数据库,指出了该方法早期检测潜在 DDI 的可能性。总之,所提出的方法具有更高的灵敏度和新的标准,可以早期检测潜在的 DDI,前提是具有类似观察-预期比值的类似药物与待评估药物相似。