Figures from the Editor's selected issue highlights will be displayed each month in the journal image carousel on the BJCP homepage http://bpspubs.onlinelibrary.wiley.com/hub/journal/10.1111/(ISSN)1365-2125/
Identifying signals of interest when screening for drug‐outcome associations in health care data
Anton Pottegård, Jesper Hallas, Shirley V. Wang and Joshua J. Gagne
DOI:https://doi.org/10.1111/bcp.13634
The editorial by Anton Pottegård et al. highlights something we will see more and more. The neat world of controlled trials with data that could be handled by techniques we all know and often just eyeballed by making a graph is coming to an end. Large numbers of measurements on small patient groups like genomic data, or very large groups with small numbers of data per subject, all result in the same thing. A lot of data. It will be clear to everyone that the techniques to sort the signals from the noise are not your familiar t‐test anymore. Read this introduction!
Genotype‐guided warfarin dosing vs. conventional dosing strategies: a systematic review and meta‐analysis of randomized controlled trials
Gary Tse, Mengqi Gong, Guangping Li, Sunny Hei Wong, William K. K. Wu, Wing Tak Wong, Leonardo Roever, Alex Pui Wai Lee, Gregory Y. H. Lip, Martin C. S. Wong, Tong Liu and International Health Informatics Study (IHIS) Network
DOI:https://doi.org/10.1111/bcp.13621
Comment on ‘Genotype‐guided warfarin dosing vs. conventional dosing strategies: a systematic review and meta‐analysis of randomized clinical trials’ by Tse et al.
Kannan Sridharan and Reginald P. Sequeira
DOI:https://doi.org/10.1111/bcp.13648
Reply to ‘Comment on ‘Genotype‐guided warfarin dosing vs. conventional dosing strategies: a systematic review and meta‐analysis of randomized clinical trials' by Tse et al.’
Gary Tse, Leonardo Roever, Martin C. S. Wong, Gregory Y. H. Lip, Tong Liu and International Health Informatics Study (IHIS) Network
DOI:https://doi.org/10.1111/bcp.13658
Gary Tse from Hong Kong and others reviewed the evidence for genotyping guided warfarin dosage and there is some associated correspondence about the paper in this issue. Warfarin treatment has a fairly small therapeutic margin and much interindividual variability and hence is always dosed with an added monitoring service which keeps the INR in a desirable range for the condition treated. Although genotype guided dosing will remove some of the variability, much is also dependent upon a good anticoagulant monitoring system. The results bear this out in the sense that genotype guided dosing produced less bleeding, however whatever bleeding there was it did not kill the patients, as there was no effect on thromboembolism or mortality. It would have been interesting to see if there was an association between the quality of the anticoagulant service and the effect of genotype based dosing.
Stakeholders' views and experiences of pharmacist prescribing: a systematic review
Tesnime Jebara, Scott Cunningham, Katie MacLure, Ahmed Awaisu, Abdulrouf Pallivalapila and Derek Stewart
DOI:https://doi.org/10.1111/bcp.13624
Tesnime Jebara from Scotland and colleagues have appraised the published papers covering the prescribing of drugs by pharmacists. They must have been unaware of the fact that in 1240, several hundred years after pharmacies started to appear in Europe (an Arabian influence), Frederick II of Hohenstaufen, who was Emperor of Germany and King of Sicily, issued a European edict completely separating pharmacy from medicine. When highlighting this paper, we could not resist mentioning the issuing of the edict. Clearly ignoring Frederick, all authors were positive about prescribing pharmacists. The negative side is also covered in this interesting review, and this was presumably the complex communication and conflicts of interest that Frederick II was trying to avoid.
Pharmacokinetics and safety of fluconazole and micafungin in neonates with systemic candidiasis: a randomized, open‐label clinical trial
S. Leroux, E. Jacqz‐Aigrain, V. Elie, F. Legrand, C. Barin‐Le Guellec, B. Aurich, V. Biran, B. Dusang, S. Goudjil, S. Coopman, R. Garcia Sanchez, W. Zhao, P. Manzoni and on behalf of the FP7 TINN (Treat Infections in NeoNates) consortium
DOI:https://doi.org/10.1111/bcp.13628
Stéphanie Leroux et al. looked at the pharmacokinetics and safety of fluconazole and micafungin in neonates. There is not enough blood in them to get a full pharmacokinetic curve, so the authors did sparse sampling and worked out that the neonates required higher dosage. This was done by Monte Carlo simulation, so these subjects were in the casino earlier than many of their contemporaries will be.
Gestational changes in buprenorphine exposure: A physiologically‐based pharmacokinetic analysis
Hongfei Zhang, Hari V. Kalluri, Jaime R. Bastian, Huijun Chen, Ali Alshabi, Steve N. Caritis and Raman Venkataramanan
DOI:https://doi.org/10.1111/bcp.13642
Hongfei Zhang and colleagues defied the notion that one cannot be pregnant a little by introducing a whole new concept ‐ the virtual pregnancy. To be able to study the pharmacokinetics of buprenorphine in pregnancy, they constructed a physiological pharmacokinetic model of pregnancy and used this to study sparse data from real patients who were pregnant and on buprenorphine. The data agreed well, so a virtual pregnancy is much like the real thing, at least in the eyes of the PK modeler. Another example of the originality and innovation that we always find amongst our contributors.
Safety, tolerability and pharmacokinetics/pharmacodynamics of the adrenomedullin antibody adrecizumab in a first‐in‐human study and during experimental human endotoxaemia in healthy subjects
Christopher Geven, Dirk van Lier, Alice Blet, Roel Peelen, Bas ten Elzen, Alexandre Mebazaa, Matthijs Kox and Peter Pickkers
DOI:https://doi.org/10.1111/bcp.13655
Chistopher Geven from Nijmegen in the Netherlands et al. found that patients with sepsis have increased adrenomedullin (ADM) and it makes sense to block this with an antibody (adrecizumab) as a potential treatment, although positive effects of ADM have also been described. The antibody produced an interesting and very clear increase of ADM, which appeared not to be caused by increased production. In a group of healthy subjects with experimental endotoxemia (by LPS infusion) there was not much effect of blockade. A major study nevertheless, and another that reminds us that sepsis is never simple and that it is good that research continues.