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  1. Article ; Online: Reply: Misidentified Dopamine Agonists Undermine Investigation Into Aripiprazole Link With Impulse Control Disorders.

    Etminan, Mahyar / Sodhi, Mohit / Carleton, Bruce

    Journal of clinical psychopharmacology

    2023  Volume 43, Issue 2, Page(s) 191–193

    MeSH term(s) Humans ; Aripiprazole ; Dopamine Agonists ; Disruptive, Impulse Control, and Conduct Disorders/drug therapy ; Antipsychotic Agents/therapeutic use
    Chemical Substances Aripiprazole (82VFR53I78) ; Dopamine Agonists ; Antipsychotic Agents
    Language English
    Publishing date 2023-02-01
    Publishing country United States
    Document type Letter ; Comment
    ZDB-ID 604631-9
    ISSN 1533-712X ; 0271-0749
    ISSN (online) 1533-712X
    ISSN 0271-0749
    DOI 10.1097/JCP.0000000000001675
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: The Role of Pharmacogenomics in Rare Diseases.

    Man, Alice / Groeneweg, Gabriella S S / Ross, Colin J D / Carleton, Bruce C

    Drug safety

    2024  

    Abstract: Rare diseases have become an increasingly important public health priority due to their collective prevalence and often life-threatening nature. Incentive programs, such as the Orphan Drug Act have been introduced to increase the development of rare ... ...

    Abstract Rare diseases have become an increasingly important public health priority due to their collective prevalence and often life-threatening nature. Incentive programs, such as the Orphan Drug Act have been introduced to increase the development of rare disease therapeutics. While the approval of these therapeutics requires supportive data from stringent pre-market studies, these data lack the ability to describe the causes of treatment response heterogeneity, leading to medications often being more harmful or less effective than predicted. If a Goal Line were to be used to describe the multifactorial continuum of phenotypic variations occurring in response to a medication, the 'Goal Posts', or the two defining points of this continuum, would be (1) Super-Response, or an extraordinary therapeutic effect; and (2) Serious Harm. Investigation of the pharmacogenomics behind these two extreme phenotypes can potentially lead to the development of new therapeutics, help inform rational use criteria in drug policy, and improve the understanding of underlying disease pathophysiology. In the context of rare diseases where cohort sizes are smaller than ideal, 'small data' and 'big data' approaches to data collection and analysis should be combined to produce the most robust results. This paper presents the importance of studying drug response in parallel to other research initiatives in rare diseases, as well as the need for international collaboration in the area of rare disease pharmacogenomics.
    Language English
    Publishing date 2024-03-14
    Publishing country New Zealand
    Document type Journal Article
    ZDB-ID 1018059-x
    ISSN 1179-1942 ; 0114-5916
    ISSN (online) 1179-1942
    ISSN 0114-5916
    DOI 10.1007/s40264-024-01416-6
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Which children are still dying from asthma? A 13 year review of pediatric asthma deaths in British Columbia, Canada.

    Cook, Victoria E / Seear, Michael / Carleton, Bruce / Yang, Connie L

    Pediatric pulmonology

    2023  Volume 58, Issue 7, Page(s) 2166–2169

    MeSH term(s) Child ; Humans ; British Columbia/epidemiology ; Canada/epidemiology ; Asthma/epidemiology
    Language English
    Publishing date 2023-05-03
    Publishing country United States
    Document type Letter
    ZDB-ID 632784-9
    ISSN 1099-0496 ; 8755-6863
    ISSN (online) 1099-0496
    ISSN 8755-6863
    DOI 10.1002/ppul.26441
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: Development of a Dose-Adjusted Polygenic Risk Model for Anthracycline-Induced Cardiotoxicity.

    Siemens, Angela / Rassekh, Shahrad Rod / Ross, Colin J D / Carleton, Bruce C

    Therapeutic drug monitoring

    2023  Volume 45, Issue 3, Page(s) 337–344

    Abstract: Background: Anthracyclines, which are effective chemotherapeutic agents, cause cardiac dysfunction in up to 57% of patients. The cumulative anthracycline dose is a crucial predictor of cardiotoxicity; however, the cumulative dose alone cannot explain ... ...

    Abstract Background: Anthracyclines, which are effective chemotherapeutic agents, cause cardiac dysfunction in up to 57% of patients. The cumulative anthracycline dose is a crucial predictor of cardiotoxicity; however, the cumulative dose alone cannot explain all cardiotoxic events. Strongly associated genetic variants in SLC28A3 , UGT1A6 , and RARG contribute to anthracycline-induced cardiotoxicity in pediatric patients and may help identify those most susceptible. This study aimed to examine how these pharmacogenetic effects are modulated by cumulative anthracycline doses in the development of cardiotoxicity.
    Methods: A total of 595 anthracycline-treated children were genotyped and cardiotoxicity cases were identified. A dose-stratified analysis was performed to compare the contributions of SLC28A3 rs7853758, UGT1A6 rs17863783, and RARG rs2229774 variants to the development of cardiotoxicity in low-dose (<150 mg/m 2 cumulative dose) and high-dose (>250 mg/m 2 cumulative dose) patient groups. Logistic regression was used to model the relationships between the cumulative anthracycline dose, genetic variants, and cardiotoxicity in the full cohort.
    Results: At < 150 mg/m 2 cumulative anthracycline dose, the SLC28A3 protective variant did not reach statistical significance [odds ratio (OR) 0.46 (95% confidence interval (CI) 0.10-1.45), P = 0.23], but it was statistically significant at doses >250 mg/m 2 [OR 0.43 (95% CI 0.22-0.78), P = 0.0093]. Conversely, the UGT1A6 and RARG risk variants were either statistically significant or approaching significance at doses <150 mg/m 2 [OR 7.18 (95% CI 1.78-28.4), P = 0.0045 for UGT1A6 and OR 2.76 (95% CI 0.89-7.63), P = 0.057 for RARG ], but not at doses >250 mg/m 2 [OR 2.91 (95% CI 0.80-11.0), P = 0.10; OR 1.56 (95% CI 0.89-2.75), P = 0.12].
    Conclusions: These findings suggest that the SLC28A3 variant imparts more significant protection for patients receiving higher anthracycline doses, whereas the UGT1A6 and RARG risk variants significantly increased the risk of cardiotoxicity at low anthracycline doses.
    MeSH term(s) Humans ; Child ; Anthracyclines/adverse effects ; Cardiotoxicity/genetics ; Cardiotoxicity/drug therapy ; Antibiotics, Antineoplastic
    Chemical Substances Anthracyclines ; Antibiotics, Antineoplastic
    Language English
    Publishing date 2023-01-12
    Publishing country United States
    Document type Journal Article
    ZDB-ID 424443-6
    ISSN 1536-3694 ; 0163-4356
    ISSN (online) 1536-3694
    ISSN 0163-4356
    DOI 10.1097/FTD.0000000000001077
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article: Editorial: Real-World Evidence of Pediatric Exposure to Psychopharmacologic Medications.

    Zito, Julie M / DosReis, Susan / Carleton, Bruce

    Frontiers in psychiatry

    2022  Volume 13, Page(s) 930276

    Language English
    Publishing date 2022-06-10
    Publishing country Switzerland
    Document type Editorial
    ZDB-ID 2564218-2
    ISSN 1664-0640
    ISSN 1664-0640
    DOI 10.3389/fpsyt.2022.930276
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Paediatric oral formulations: Why don't our kids have the medicines they need?

    Juárez-Hernández, José Eduardo / Carleton, Bruce C

    British journal of clinical pharmacology

    2022  Volume 88, Issue 10, Page(s) 4337–4348

    Abstract: Medication use in children represents 15-20% of total drug sales. More than 50% of children receive at least one prescription medication a year. Despite this, few drugs have a paediatric formulation available. Furthermore, 80% of paediatric prescriptions ...

    Abstract Medication use in children represents 15-20% of total drug sales. More than 50% of children receive at least one prescription medication a year. Despite this, few drugs have a paediatric formulation available. Furthermore, 80% of paediatric prescriptions are considered off-label. Off-label use is defined as the use of products that differ in dose, indication or route of administration from the one established in the summary of product characteristics. Off-label use is associated with an increased risk of adverse drug reactions, including therapeutic failure. The US Food and Drug Administration and the European Medicines Agency have made changes to regulations to incentivize the development of paediatric formulations. Novel paediatric formulations can ease drug administration, reducing medication errors, increasing dosing acceptability, medication adherence and improve safety. Two routes for paediatric drug approval are available, the traditional, requiring clinical trials and the formulation bridging path, where these formulations need to demonstrate equivalence with the existing adult formulations. New formulations seeking regulatory approval require bioequivalence studies, but the regulatory framework, which states that bioequivalence data are obtained from adults and then extrapolated to children, may be disregarding important physiological differences between these two populations of patients. It is important to ensure that drugs for children have been appropriately studied and are properly manufactured for them. Adequately designed studies will provide data that will improve our understanding of how drug disposition differs between adults and children and will pave the way for children to get the best possible treatment.
    MeSH term(s) Adult ; Child ; Drug Approval ; Drug-Related Side Effects and Adverse Reactions ; Humans ; Pharmaceutical Preparations ; Therapeutic Equivalency ; United States ; United States Food and Drug Administration
    Chemical Substances Pharmaceutical Preparations
    Language English
    Publishing date 2022-07-23
    Publishing country England
    Document type Journal Article ; Review
    ZDB-ID 188974-6
    ISSN 1365-2125 ; 0306-5251 ; 0264-3774
    ISSN (online) 1365-2125
    ISSN 0306-5251 ; 0264-3774
    DOI 10.1111/bcp.15456
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: COVID-19 pathophysiology and pharmacology: what do we know and how did Canadians respond? A review of Health Canada authorized clinical vaccine and drug trials.

    Diab, Antonios M / Carleton, Bruce C / Goralski, Kerry B

    Canadian journal of physiology and pharmacology

    2021  Volume 99, Issue 6, Page(s) 577–588

    Abstract: Coronavirus disease 2019 (COVID-19) has resulted in the death of over 18 000 Canadians and has impacted the lives of all Canadians. Many Canadian research groups have expanded their research programs to include COVID-19. Over the past year, our knowledge ...

    Abstract Coronavirus disease 2019 (COVID-19) has resulted in the death of over 18 000 Canadians and has impacted the lives of all Canadians. Many Canadian research groups have expanded their research programs to include COVID-19. Over the past year, our knowledge of this novel disease has grown and has led to the initiation of a number of clinical vaccine and drug trials for the prevention and treatment of COVID-19. Here, we review SARS-CoV-2 (the coronavirus that causes COVID-19) and the natural history of COVID-19, including a timeline of disease progression after SARS-CoV-2 exposure. We also review the pathophysiological effects of COVID-19 on the organ systems that have been implicated in the disease, including the lungs, upper respiratory tract, immune system, central nervous system, cardiovascular system, gastrointestinal organs, the liver, and the kidneys. Then we review general therapeutics strategies that are being applied and investigated for the prevention or treatment of COVID-19, including vaccines, antivirals, immune system enhancers, pulmonary supportive agents, immunosuppressants and (or) anti-inflammatories, and cardiovascular system regulators. Finally, we provide an overview of all current Health Canada authorized clinical drug and vaccine trials for the prevention or treatment of COVID-19.
    MeSH term(s) Antiviral Agents/therapeutic use ; COVID-19/drug therapy ; COVID-19/immunology ; COVID-19/prevention & control ; COVID-19 Vaccines/immunology ; Canada ; Humans ; Immune System/drug effects ; Immune System/immunology ; Lung/drug effects ; Lung/immunology ; SARS-CoV-2/drug effects ; SARS-CoV-2/immunology
    Chemical Substances Antiviral Agents ; COVID-19 Vaccines
    Language English
    Publishing date 2021-04-14
    Publishing country Canada
    Document type Journal Article ; Review
    ZDB-ID 127527-6
    ISSN 1205-7541 ; 0008-4212
    ISSN (online) 1205-7541
    ISSN 0008-4212
    DOI 10.1139/cjpp-2021-0038
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Benefits v. risks of COVID-19 vaccination: an examination of vaccination policy impact on the occurrence of myocarditis and pericarditis.

    Carleton, Bruce C / Salmon, Daniel A / Ip, Patrick / Wong, Ian C K / Lai, Francicso T T

    The Lancet regional health. Western Pacific

    2023  , Page(s) 100797

    Abstract: Studies of myocarditis/pericarditis following mRNA COVID-19 vaccines in Hong Kong have been published. Data are consistent with data from other active surveillance or healthcare databases. The mRNA COVID-19 vaccines have been shown to rarely increase ... ...

    Abstract Studies of myocarditis/pericarditis following mRNA COVID-19 vaccines in Hong Kong have been published. Data are consistent with data from other active surveillance or healthcare databases. The mRNA COVID-19 vaccines have been shown to rarely increase risk of myocarditis, with the highest risk among males aged 12-17 after the second dose. An increased risk of pericarditis has also been shown after the second dose, though less common than myocarditis and more evenly distributed among different sex and age groups. Because of the increased risk of post-vaccine myocarditis, Hong Kong implemented a single dose mRNA COVID-19 vaccine policy on September 15, 2021 for adolescents (age 12-17 years). Post-policy, there were no cases of carditis. 40,167 first dose patients did not receive a second dose. This policy was highly successful in the reduction of carditis, but the trade-off is the potential risk of disease and cost to population-level immunity. This commentary brings forward some important global policy considerations.
    Language English
    Publishing date 2023-05-19
    Publishing country England
    Document type Journal Article ; Review
    ISSN 2666-6065
    ISSN (online) 2666-6065
    DOI 10.1016/j.lanwpc.2023.100797
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: The incidence of symptomatic osteonecrosis after allogeneic haematopoietic stem cell transplantation in children with acute lymphoblastic leukaemia - controversy on dexamethasone as a risk factor.

    Tanoshima, Reo / Carleton, Bruce C

    British journal of haematology

    2018  Volume 185, Issue 5, Page(s) 958–959

    MeSH term(s) Child ; Dexamethasone ; Hematopoietic Stem Cell Transplantation ; Humans ; Incidence ; Osteonecrosis ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Risk Factors
    Chemical Substances Dexamethasone (7S5I7G3JQL)
    Language English
    Publishing date 2018-11-08
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 80077-6
    ISSN 1365-2141 ; 0007-1048
    ISSN (online) 1365-2141
    ISSN 0007-1048
    DOI 10.1111/bjh.15657
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Pharmacogenomics in Pediatric Oncology: Mitigating Adverse Drug Reactions While Preserving Efficacy.

    Elzagallaai, Abdelbaset A / Carleton, Bruce C / Rieder, Michael J

    Annual review of pharmacology and toxicology

    2020  Volume 61, Page(s) 679–699

    Abstract: Cancer is the leading cause of death in American children older than 1 year of age. Major developments in drugs such as thiopurines and optimization in clinical trial protocols for treating cancer in children have led to a remarkable improvement in ... ...

    Abstract Cancer is the leading cause of death in American children older than 1 year of age. Major developments in drugs such as thiopurines and optimization in clinical trial protocols for treating cancer in children have led to a remarkable improvement in survival, from approximately 30% in the 1960s to more than 80% today. Short-term and long-term adverse effects of chemotherapy still affect most survivors of childhood cancer. Pharmacogenetics plays a major role in predicting the safety of cancer chemotherapy and, in the future, its effectiveness. Treatment failure in childhood cancer-due to either serious adverse effects that limit therapy or the failure of conventional dosing to induce remission-warrants development of new strategies for treatment. Here, we summarize the current knowledge of the pharmacogenomics of cancer drug treatment in children and of statistically and clinically relevant drug-gene associations and the mechanistic understandings that underscore their therapeutic value in the treatment of childhood cancer.
    MeSH term(s) Antineoplastic Agents/therapeutic use ; Child ; Child, Preschool ; Drug-Related Side Effects and Adverse Reactions ; Humans ; Neoplasms/drug therapy ; Pharmacogenetics
    Chemical Substances Antineoplastic Agents
    Language English
    Publishing date 2020-09-25
    Publishing country United States
    Document type Journal Article
    ZDB-ID 196587-6
    ISSN 1545-4304 ; 0362-1642
    ISSN (online) 1545-4304
    ISSN 0362-1642
    DOI 10.1146/annurev-pharmtox-031320-104151
    Database MEDical Literature Analysis and Retrieval System OnLINE

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