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Scientists see progress in identifying deadly drug interactions


A new method of mining data shows great promise in identifying dangerous drug interactions that had been overlooked by more traditional approaches, according to a new study in a top cardiovascular journal.

The study by scientists at Columbia University Medical Center was the result of a unique collaboration with the Chicago Tribune, which set out to do what had never been done before: search the vast universe of prescription medications to discover which combinations might trigger a potentially fatal heart arrhythmia.

By examining big data in entirely new ways, the team uncovered several drug combinations associated with increased risk. One pair included the popular antibiotic ceftriaxone and the heartburn medication lansoprazole, a former blockbuster drug best known by the brand name Prevacid. The Tribune reported on the results in February.

On Monday, the Journal of the American College of Cardiology published a paper by the scientists involved in the project, along with an editorial that calls the research “an important new contribution” in the effort to identify drug interactions.

“The results and their interpretation,” wrote Dr. Dan Roden, a leading expert on cardiac arrhythmia at Vanderbilt University who was not involved in the research, “provide important lessons for investigators interested in using ‘big data’ approaches to study (adverse drug reactions), other drug effects and indeed, many other aspects of the human condition.”

The study stated that an interaction between ceftriaxone and lansoprazole “has the potential for significant morbidity and mortality.” But the scientists said more research was needed, a conclusion shared by Roden. The results, he wrote, are probably not sufficient at this point to advise doctors to avoid the drug combination.

In an interview, Roden said the study demonstrates that “big data sets offer us the opportunity to find things that we wouldn’t be able to find otherwise.”

“The message for the community is: Stay tuned. There are going to be a lot more ways of analyzing these big data sets,” he said.

Some drug interactions are well-documented, but many remain hidden and may come to light only after a large number of patients have been harmed.

“It is no longer sufficient to take a wait-and-hope approach,” Nicholas Tatonetti, a Columbia data scientist and one of the authors of the paper, said in an interview. “Our study demonstrates that we may be able to take a more active strategy for drug combination safety.”

Dr. Raymond Woosley, an author of the study and former dean of the University of Arizona medical school, lauded the research collaboration between the Tribune and the scientists.

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