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Which tool is best for screening interactions between herbal supplements, anticancer agents?

07 Jan 2021

The best available tool for detecting herb–drug interaction is Lexicomp, and the best free alternative is Medscape, suggests a study. However, the sensitivity and performance for detecting herb–drug interaction is far lower than for drug–drug interactions and quite poor overall.

“Several screening tools exist to detect drug–drug interactions, but their performance to detect herb–drug interactions is not known,” the authors said. “This study compared the performance of eight drug–drug interaction screening tools to detect herb–drug interaction with anticancer agents.

An assessment was carried out on the herb–drug interaction performance of four subscription (Micromedex, Lexicomp, PEPID, Facts & Comparisons) and free (Drugs.com, Medscape, WebMD, RxList) drug–drug interaction tools.

The authors determined the clinical relevance of each herb–drug interaction using Natural Medicine and each drug-drug interaction tool. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated using descriptive statistics. Finally, the performance between subscription and free tools was compared using linear regression.

All tools showed poor sensitivity (<0.20) for screening interactions between herbal supplements and anticancer drugs. Lexicomp had the highest positive predictive value (0.98) and best overall performance score (0.54). Among free tools, Medscape showed the best performance (0.52).

The worst subscription tools were as good as or better than the best free tools. As a group, subscription tools outperformed free tools on all metrics. Using an average subscription tool would detect one additional herb–drug interaction for every 10 herb–drug interactions detected by a free tool.

“Further research is needed to improve herb–drug interaction screening performance,” the authors said.

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Most Read Articles
01 Dec 2020
Tetanus toxoid 5 Lf, diphtheria toxoid 2 Lf, pertussis toxoid 2.5 mcg, filamentous haemagglutinin 5 mcg, fimbriae types 2 and 3 5 mcg, pertactin 3 mcg
Dr. Hsu Li Yang, Dr. Tan Thuan Tong, Dr. Andrea Kwa, 08 Jan 2021
Antimicrobial resistance has become increasingly dire as the rapid emergence of drug resistance, especially gram-negative pathogens, has outpaced the development of new antibiotics. At a recent virtual symposium, Dr Hsu Li Yang, Vice Dean (Global Health) and Programme Leader (Infectious Diseases), NUS Saw Swee Hock School of Public Health, presented epidemiological data on multidrug-resistant (MDR) gram-negative bacteria (GNB) in Asia, while Dr Tan Thuan Tong, Head and Senior Consultant, Department of Infectious Diseases, Singapore General Hospital (SGH), focused on the role of ceftazidime-avibactam in MDR GNB infections. Dr Andrea Kwa, Assistant Director of Research, Department of Pharmacy, SGH, joined the panel in an interactive fireside chat, to discuss challenges, practical considerations, and solutions in MDR gram-negative infections. This Pfizer-sponsored symposium was chaired by Dr Ng Shin Yi, Head and Senior Consultant of Surgical Intensive Care, SGH.
Pearl Toh, 26 Nov 2020
Inhaled corticosteroid (ICS) should be the mainstay of long-term asthma management — such is the key message of the latest Singapore ACE* Clinical Guidance (ACG) for asthma, released in October 2020.
Yesterday
Daily intake of cow’s milk formula in early life helps prevent the development of cow’s milk allergy later on without competing with breastfeeding, a recent study has found.