Ethnic differences in risks of adverse reactions: Is personalised drug treatment better with pharmacokinetic modelling?

doi:10.1136/bmj.332.7554.1393

BMJ 2006;332:1393 (10 June), doi:10.1136/bmj.332.7554.1393

Letter

Ethnic differences in risks of adverse reactions

Is personalised drug treatment better with pharmacokinetic modelling?

The first 150 words of the full text of this article appear below.

EDITOR—McDowell et al conclude that patients from differentethnic groups have different risks for important adverse drugreactions on the basis of a meta-analysis of adverse reactionsdue to drugs used in cardiovascular medicine.¹ Data are sparse,and regulators should ask for better data before licensing.

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The use of pharmacokinetic and pharmacodynamic modelling wouldgreatly facilitate this process. The European Commission sponsoreda workshop to facilitate the incorporation of such modellingstudies into drug development. Data from 1997 on naratriptan,a serotonin agonist treatment for acute migraine, used a populationapproach and Bayesian predictions to examine the pharmacokineticand pharmacodynamic relations for oral naratriptan during phaseII clinical trials.² Hepatic clearance of naratriptan declinedwith age and use of hormone contraception, potentially increasingthe likelihood of adverse events leading to product labellingrestrictions for elderly patients and leading to higher efficacyin women.³ In tobacco smokers and black . . . [Full text of this article]

David S Millson, general practitioner principal

Leek Health Centre, Leek ST13 6JB david.millson@tiscali.co.uk

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