Minutes from the 10/18 PDDI Task Force CONTENT sub-team meeting, next meeting dates

Hi,

The minutes and recording link from the CONTENT sub-team of the PDDI 
Information Task Force  are pasted below. The next meetings for our 
sub-teams are as follows:

CONTENT: Wednesday, November 16th at 1pm Eastern (10am Pacific)

STANDARD: Monday, November 21st from 2-3pm Eastern time.

Telecon information can be found on the project page: 
(https://goo.gl/KziIVE)

best, -R


    Minutes for 10/18/16 (Content Subgroup)

In Attendance:  Dan Malone, Evan Draper, Brian LeBaron, Richard Boyce

Meeting recording: https://goo.gl/8LMxYN

Meeting:

  *

    Decision tree status

  *

    Tyrosine kinase inhibitors + proton pump inhibitors

      o

        Consulted John and 4 other clinical institutions

          +

            No standard for clinicians, just follow package inserts

          +

            Keep original decision tree format

      o

        Addressed remaining issues

1)  added comment pH is absorbent dependent

2)  incorporated article from John Horn

3) How do we best model new evidence with clinicians? More implications?

      o

        Finalize footnotes and overall piece for next time

  *

    Warfarin + etoposide/ifosfamide

      o

        DIPS score analysis

          +

            Ranges from 1-7, most between a 2 or 3

          +

            Update reference list with DIPS sources

          +

            Fill out DIPS spreadsheet

      o

        Finalize for next time

  *

    Tamoxifen + paroxetine

  *

    How do we categorize bupropion and duloxetine?

  *

    Bupropion

      o

        Not a particularly strong inhibitor of 2D6 but acts as one
        depending on dosage

      o

        Not a good relationship in terms of AUC

      o

        Notion is AUC studies used moderate dosages, consider use of
        higher dosages –  would have a much larger effect

  *

    Duloxetine

      o

        Parallel classification on FDA website

      o

        Substantial affect (290% AUC) but much less than fluconazole
        (480% AUC)

      o

        Do we have a good definition for what percent change in AUC is
        considered a strong, moderate, or weak inhibitor?

  *

    Things to consider

      o

        Change in AUC may depend on the therapeutic index of the drug

      o

        Substrate being tested

      o

        For clinical application of this decision tree, clear
        distinction between strong and moderate inhibitors may not be needed

          +

            Duloxetine is strong compared to other weak inhibitors

          +

            Gap works well for this study

      o

        How often is Taxoxifen used?

      o

        Is there any reason why you would continue the use of Tamoxifen
        compared to using another drug?

  *

    Finalize for next time

  *

    Upcoming Meeting

  *

    November 15th/16that 1pm Eastern time?

  *

    Goals:

      o

        Briefly reviewed finalized decision trees

          +

            Tyrosine kinase inhibitors + proton pump inhibitors

          +

            Warfarin + etoposide/ifosfamide

          +

            Tamoxifen + paroxetine

§ John: Amiodarone + Simvastatin, Fluconazole + Simvastatin

§ Introductory note

§ Edit version 1 draft

§ Review other decision tree interactions


-- 
Richard D Boyce, PhD
Associate Professor of Biomedical Informatics and Clinical and Translational Science in the Clinical and Translational
Science Institute
Faculty, Center for Pharmaceutical Policy and Prescribing
Faculty, Geriatric Pharmaceutical Outcomes and Gero-Informatics Research and Training Program
University of Pittsburgh
rdb20@pitt.edu
Office: 412-648-9219
Twitter: @bhaapgh