Patients often don’t get the correct dosage of a drug because most of the research has been done on healthy white males between the ages of 18 and 55. This creates an “average” dose that is often not optimal for, for example, children or people with a different genetic profile, says new clinical pharmacometry professor Birgit Koch of Erasmus MC, who will give her inaugural lecture this afternoon. live broadcast can be followed. “For example, when children are using antipsychotics, we see that 20-40% have a lot of side effects, such as heavy weight gain. Often they have to stop therapy for this reason ”.
In his inaugural lecture “Everyone is a bit average,” Koch also mentions the dosage of antibiotics, such as amoxicillin, of which everyone is now receiving the same dose. “It is possible that patients receive too low a dose, but we do not know this because many drugs have not been studied in terms of dosage, concentration or effect. This has never even been studied for all medicines before 1995 ”.
Koch advises pharmacists not to take the average patient too easily and, for example, to find out first which target group has been tested. “An adverse reaction can occur even if it is not mentioned in the registration text. For example, women often experience very different side effects than men ”.
Research in the United States shows that 10 years after registration, 40 percent of the drugs reported side effects that weren’t previously known, according to Koch.
Software house
With the help of new algorithms and patient records, greater customization in dosing can be provided, but according to Koch, the pharmacy information systems need to integrate more variables, such as BMI, pharmacogenetics and underlying suffering. “We now know a lot about the use of drugs in different patient groups, but software houses’ implementation of patient characteristics is far behind.”
Koch also supports research from the pharmaceutical industry among the right target groups. “Which patients will ultimately use a medicine, the industry needs to ask this question more often. This also means more research on women and children.”
First chair
This is the world’s first chair in the field of clinical pharmacometry – applying the optimal dosage for a particular patient – but this requires some qualification, according to Koch. “Of course there are more professors, for example in clinical pharmacology, who are working on individualized dosing. But I am happy that more attention is being paid to this topic. “
In the next period, Koch will be involved, among other things, in the implementation of algorithms in the hospital information system at Erasmus MC. He will also do it together with Eindhoven University of Technology real time measure blood values in patient tests. “Ultimately, we can adjust a dosage immediately through home monitoring.”
