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Skalli S, Caro-Rojas A, Rostom H, Elhawary MA. A Framework for Promoting Safety Monitoring of Herbal Medicines: The International Society of Pharmacovigilance Special Interest Group on Herbal and Traditional Medicines. Drug Saf 2024; 47:515-520. [PMID: 38717671 DOI: 10.1007/s40264-024-01440-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2024] [Indexed: 05/25/2024]
Affiliation(s)
- Souad Skalli
- Plant and Microbial Biotechnologies, Biodiversity, and Environment Center, Faculty of Science Mohammed, V University (Chair of ISoP H&TMs SIG), Rabat, Morocco
| | - Angela Caro-Rojas
- International Society of Pharmacovigilance, ISoP Secretariat Ltd, London, UK
- Pharmacy Career Director of Pontificia Universidad Javeriana (President of ISoP), Bogotá, Colombia
| | - Hadir Rostom
- International Society of Pharmacovigilance (ISoP) Egypt Chapter, Cairo, Egypt
- Faculty of Pharmacy, MSA University (President of ISoP Egypt Chapter), 6th of October City, Giza, Egypt
| | - Mohamed A Elhawary
- Egyptian Ministry of Health and Population, Central Administration for Pharmaceutical Affairs (Research Coordinator of ISoP Egypt Chapter), Cairo, Egypt.
- Faculty of Pharmacy, Ain shams University, Cairo, Egypt.
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Elhawary MA, Ogar CK, Tarapués M, Caro A, Ndagije HB, Benabdallah G, Sefiani H, Rostom H. The Role of ISoP in the Advancement of Pharmacovigilance in Low-and Middle-Income Countries (LMICs). Drug Saf 2023; 46:1307-1312. [PMID: 37874450 DOI: 10.1007/s40264-023-01363-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2023] [Indexed: 10/25/2023]
Affiliation(s)
- Mohamed A Elhawary
- Egyptian Ministry of Health and Population, Central Administration for Pharmaceutical Affairs (Research Coordinator of ISoP Egypt Chapter in His Personal Capacity), Cairo, Egypt.
- International Society of Pharmacovigilance (ISoP) Egypt Chapter, Cairo, Egypt.
| | - Comfort K Ogar
- International Society of Pharmacovigilance (ISoP) Africa Chapter, Abuja, Nigeria
- Utrecht Centre for Pharmaceutical Policy and Regulation, Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Utrecht University (General Secretary of ISoP Africa Chapter), Utrecht, The Netherlands
| | - Mónica Tarapués
- International Society of Pharmacovigilance, ISoP Secretariat Ltd, London, UK
- International Society of Pharmacovigilance (ISoP) Latin America (LATAM) Chapter (General Secertary of ISoP), Quito, Ecuador
| | - Angela Caro
- International Society of Pharmacovigilance, ISoP Secretariat Ltd, London, UK
- Pharmacy Career Director of Pontificia, Universidad Javeriana (President of ISoP), Bogotá, Colombia
| | - Helen Byomire Ndagije
- International Society of Pharmacovigilance (ISoP) Africa Chapter, Kampala, Uganda
- National Drug Authority, Directorate of Product Safety (President of ISoP Africa Chapter), Kampala, Uganda
| | - Ghita Benabdallah
- International Society of Pharmacovigilance (ISoP) Middle East Chapter, Rabat, Morocco
- Centre Anti Poison et de Pharmacovigilance du Maroc, Rabat WHO Collaborating Centre, Rabat, Morocco
| | - Houda Sefiani
- International Society of Pharmacovigilance (ISoP) Middle East Chapter, Rabat, Morocco
- Centre Anti Poison et de Pharmacovigilance du Maroc, Rabat WHO Collaborating Centre, Rabat, Morocco
| | - Hadir Rostom
- International Society of Pharmacovigilance (ISoP) Egypt Chapter, Cairo, Egypt
- Faculty of Pharmacy, MSA University (President of ISoP Egypt Chapter), 6th of October City, Giza, Egypt
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Villaescusa L, Zaragoza C, Zaragoza F, Tamargo J. Herbal medicines for the treatment of cardiovascular diseases: Benefits and risks- A narrative review. Int J Cardiol 2023:S0167-5273(23)00599-5. [PMID: 37116758 DOI: 10.1016/j.ijcard.2023.04.045] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 04/14/2023] [Accepted: 04/24/2023] [Indexed: 04/30/2023]
Abstract
Herbal medicines (HMs) have been traditionally used for the prophylaxis/treatment of cardiovascular diseases (CVDs). Their use is steadily increasing and many patients with CVDs often combine HMs with prescribed cardiovascular medications. Interestingly, up to 70% of patients do not notify cardiologists/physicians the use of HMs and up to 90% of cardiologists/physicians may not routinely inquire them about the use of HMs. There is limited scientific evidence from well-designed clinical trials supporting the efficacy and safety of HMs and because they do not reduce morbidity and mortality are not recommended in clinical guidelines for the prophylaxis/treatment of CVDs. There is also a great deal of confusion about the identification, active constituents and mechanisms of action of HMs; the lack of standardization and quality control (contaminations, adulterations) represent other sources of concern. Furthermore, the widespread perception that unlike prescription drugs HMs are safe is misleading and some HMs can cause clinically relevant adverse events and interactions, particularly when used with narrow therapeutic index prescribed cardiovascular drugs (antiarrhythmics, antithrombotics, digoxin). Cardiologists/physicians can no longer ignore the problem. They must improve their knowledge about the HMs their patients consume to provide the best advice and prevent adverse reactions and drug interactions. This narrative review addresses the putative mechanisms of action, suggested clinical uses and safety of most commonly used HMs, the pivotal role of cardiologists/physicians to protect consumers and the main challenges and gaps in evidence related to the use of HMs in the prophylaxis and treatment of CVDs.
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Affiliation(s)
- Lucinda Villaescusa
- Pharmacology Unit, Biomedical Sciences Department, University of Alcalá, Madrid, 28805 Alcalá de Henares, Spain.
| | - Cristina Zaragoza
- Pharmacology Unit, Biomedical Sciences Department, University of Alcalá, Madrid, 28805 Alcalá de Henares, Spain
| | - Francisco Zaragoza
- Pharmacology Unit, Biomedical Sciences Department, University of Alcalá, Madrid, 28805 Alcalá de Henares, Spain
| | - Juan Tamargo
- Department of Pharmacology and Toxicology, School of Medicine, Universidad Complutense, 28040 Madrid, Spain.
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Kiguba R, Olsson S, Waitt C. Pharmacovigilance in low- and middle-income countries: A review with particular focus on Africa. Br J Clin Pharmacol 2023; 89:491-509. [PMID: 34937122 DOI: 10.1111/bcp.15193] [Citation(s) in RCA: 47] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 12/03/2021] [Accepted: 12/15/2021] [Indexed: 01/25/2023] Open
Abstract
Low- and middle-income countries (LMIC) face unique challenges with regard to the establishment of robust pharmacovigilance systems capable of generating data to inform healthcare policy and practice. These include the limited integration and reliability of pharmacovigilance systems across LMIC despite recent efforts to harmonize pharmacovigilance rules and regulations in several regional economic communities. There are particular challenges relating to the need to translate reporting tools into numerous local languages and the low numbers of healthcare providers relative to number of patients, with very short consultation times. Additional factors frequent in LMIC include high uptake of herbal and traditional medication, mostly by self-medication; disruptive political conflicts jeopardizing fragile systems; and little or no access to drug utilization data, which makes it difficult to reliably estimate the true risks of medicines use. Pharmacovigilance activities are hindered by the scarcity of well-trained personnel with little or no budgetary support from national governments; high turnover of pharmacovigilance staff whose training involves a substantial amount of resources; and little awareness of pharmacovigilance among healthcare workers, decision makers and consumers. Furthermore, little collaboration between public health programmes and national medicines regulatory authorities coupled with limited investment in pharmacovigilance activities, especially during mass drug administration for neglected tropical diseases and mass vaccinations, produces major challenges in establishing a culture where pharmacovigilance is systematically embedded. Very low spontaneous reporting rates with poor quality reports hinders robust signal detection analyses. This review summarises the specific challenges and areas of progress in pharmacovigilance in LMIC with special focus on the situation in Africa.
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Affiliation(s)
- Ronald Kiguba
- Department of Pharmacology and Therapeutics, Makerere University, Kampala, Uganda
| | - Sten Olsson
- Pharmacovigilance Consulting, Uppsala, Sweden
| | - Catriona Waitt
- Department of Pharmacology and Therapeutics, University of Liverpool, UK.,Infectious Diseases Institute, Makerere University College of Health Sciences, Uganda
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Prevalence of traditional medicines use and adverse events: A population-based cross-sectional survey in Burkina Faso. Eur J Integr Med 2022. [DOI: 10.1016/j.eujim.2022.102129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Ouoba K, Lehmann H, Semde R, Pabst JY. [Literature review on pharmacovigilance of medicines derived from traditional pharmacopoeias. Part I: risks identification]. ANNALES PHARMACEUTIQUES FRANÇAISES 2021; 80:646-658. [PMID: 34914891 DOI: 10.1016/j.pharma.2021.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 11/07/2021] [Accepted: 11/29/2021] [Indexed: 11/16/2022]
Abstract
Globally, the use of drugs from traditional pharmacopoeias is a major subject. The confidence of the populations in these drugs is linked to their presumption of safety and also to the fact that geographically and financially they are more accessible than synthetic drugs. In view of the high exposure of the world population to traditional medicines, they are subject to pharmacovigilance guaranteeing their safety in use. Thus, this review aims to take stock of the risks identified by the national pharmacovigilance systems. It is based on research referenced in PubMed, Embase, ScienceDirect and GoogleScholar. These studies indicate that the use of traditional drugs can involve risks including adverse effects, interactions with synthetic drugs, adulteration and contamination. The spontaneous notification system was the basis for their identification. Strengthening this system and making populations aware of these risks constitute the key levers for traditional medicines pharmacovigilance progress.
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Affiliation(s)
- Kampadilemba Ouoba
- Laboratoire du Développement du Médicament (LADME), Centre de Formation, de Recherche et d'Expertises en sciences du Médicament (CEA-CFOREM), Ecole doctorale sciences et santé (ED2S), université Joseph KI-ZERBO, 03 BP 7021 Ouagadougou, Burkina Faso; EA 7307, Centre d'études internationales et européennes (CEIE), faculté de pharmacie, université de Strasbourg, 74, route du Rhin, 67400 Illkirch, France.
| | - Hélène Lehmann
- EA 4487, Centre de recherches en droit et perspectives du droit, faculté de pharmacie, université de Lille, rue du Professeur-Laguesse, BP 53, 59006 Lille, France
| | - Rasmané Semde
- Laboratoire du Développement du Médicament (LADME), Centre de Formation, de Recherche et d'Expertises en sciences du Médicament (CEA-CFOREM), Ecole doctorale sciences et santé (ED2S), université Joseph KI-ZERBO, 03 BP 7021 Ouagadougou, Burkina Faso
| | - Jean-Yves Pabst
- EA 7307, Centre d'études internationales et européennes (CEIE), faculté de pharmacie, université de Strasbourg, 74, route du Rhin, 67400 Illkirch, France
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Satwika MV, Sushma DS, Jaiswal V, Asha S, Pal T. The Role of Advanced Technologies Supplemented with Traditional Methods in Pharmacovigilance Sciences. Recent Pat Biotechnol 2021; 15:34-50. [PMID: 33087036 DOI: 10.2174/1872208314666201021162704] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 08/05/2020] [Accepted: 09/21/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND The immediate automatic systemic monitoring and reporting of adverse drug reactions, improving the efficacy is the utmost need of the medical informatics community. The venturing of advanced digital technologies into the health sector has opened new avenues for rapid monitoring. In recent years, data shared through social media, mobile apps, and other social websites has increased manifolds requiring data mining techniques. OBJECTIVE The objective of this report is to highlight the role of advanced technologies together with the traditional methods to proactively aid in the early detection of adverse drug reactions concerned with drug safety and pharmacovigilance. METHODS A thorough search was conducted on papers and patents regarding pharmacovigilance. All articles with respect to the relevant subject were explored and mined from public repositories such as Pubmed, Google Scholar, Springer, ScienceDirect (Elsevier), Web of Science, etc. Results: The European Union's Innovative Medicines Initiative WEB-RADR project has emphasized the development of mobile applications and social media data for reporting adverse effects. Only relevant data has to be captured through the data mining algorithms (DMAs) as it plays an important role in timely prediction of risk with high accuracy using two popular approaches; the frequentist and Bayesian approach. Pharmacovigilance at the pre-marketing stage is useful for the prediction of adverse drug reactions in the early developmental stage of a drug. Later, post-marketing safety reports and clinical data reports are important to be monitored through electronic health records, prescription-event monitoring, spontaneous reporting databases, etc. Conclusion: The advanced technologies supplemented with traditional technologies are the need of the hour for evaluating a product's risk profile and reducing risk in population especially with comorbid conditions and on concomitant medications.
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Affiliation(s)
- Mandali V Satwika
- Department of Biotechnology, Vignan's Foundation for Science, Technology and Research (Deemed to be University), Vadlamudi, Guntur, 522213, Andhra Pradesh, India
| | - Dudala S Sushma
- Department of Biotechnology, Vignan's Foundation for Science, Technology and Research (Deemed to be University), Vadlamudi, Guntur, 522213, Andhra Pradesh, India
| | - Varun Jaiswal
- School of Electrical and Computer Science Engineering, Shoolini University, Solan, Himachal Pradesh, 173212, India
| | - Syed Asha
- Department of Biotechnology, Vignan's Foundation for Science, Technology and Research (Deemed to be University), Vadlamudi, Guntur, 522213, Andhra Pradesh, India
| | - Tarun Pal
- Department of Biotechnology, Vignan's Foundation for Science, Technology and Research (Deemed to be University), Vadlamudi, Guntur, 522213, Andhra Pradesh, India
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