In this survey, the correlation between adverse drug reactions (ADRs) in human and animal toxicities was investigated for 393 medicines which were approved in Japan from September 1999 to March 2013. ADRs were collected from each Japanese package insert. Comparable animal toxicities with ADRs were collected by thorough investigation of common technical documents. The results of this survey show that hypertension and/or hypotension were mainly observed in medicines affecting the central nervous system. Hypertension was also observed in antipyretics, analgesics, anti-inflammatory agents, vasoconstrictors and agents using antibody. Concordance between human ADRs and animal toxicities was analysed. True-positive rate for hypertension and hypotension is 0.29 and 0.52, respectively. Positive likelihood ratio and inverse negative likelihood ratio are 1.98 and 1.21, respectively, in hypertension and 1.67 and 1.44, respectively, in hypotension. Concordance between human ADRs and animal toxicities is not so high in hypertension and hypotension. Identified mechanisms as on-target for hypertension and hypotension are 29.8% and 30.5%, respectively. More than half of the causative factors of hypertension and hypotension were unable to be elucidated. Our results show that the intake of medicines is often linked to blood pressure variations that are not predicted in animal toxicity studies. Improvement of drug development processes may be necessary to provide safer medicines because current animal toxicity studies are insufficient to predict all ADRs in human beings.A safe medicine is ideally free from adverse drug reactions (ADRs); however, it is often difficult to distinguish ADRs from the intended pharmacological action. During drug development, to select a candidate compound, every effort is made to provide safe medicines [1]. Some compounds which exhibit unacceptable toxicity in animals are discontinued from development prior to clinical studies in human beings; even so, there are no medicines without ADRs. Many medicines on the market are used with their ADRs appropriately managed in the clinical setting based on the risk: benefit ratio [2]. The aim of this survey was to clarify the correlation between ADRs in human and animal toxicities. There are some reports which have evaluated the concordance of the toxicities found in human beings and in animals [3][4][5][6][7]. In this study, we report the investigational results for hypertension and hypotension, which are clinically important and significant parameters and showed low translatability from animal toxicity in our preliminary studies [3]. These survey results are expected to contribute to constructing a safer drug development strategy, as well as ensuring the appropriate use of marketed medicines in the clinical setting, as this kind of comprehensive research concerning marketed medicines has not been common to date.
Materials and MethodsADR information for 393 human medicines approved for use in Japan as new drug substances between September 1999 and March ...