Skip to main content
Log in

On Pharmaceutical Risk Minimization

  • Current Opinion
  • Published:
Drug Safety Aims and scope Submit manuscript

Abstract

Current regulatory guidelines related to pharmaceutical risk minimization put most emphasis on risk communication and control of the use of drugs. Little, if any, consideration is given to those aspects of an adverse drug reaction that ultimately determine whether the risk can be minimized. However, this limited scope is unfortunate and could prevent risk minimization activities from improving drug use safety. This article attempts to present an overview of possible elements of pharmaceutical risk minimization and to place these in a framework. The promotion of drug safety through risk communication and control of use should be advanced, with more attention to actionable and evidence-based guidance relating to the ‘pretreatment evaluation’, and in particular the ‘on-treatment management’ of the patient.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

Notes

  1. 1Following new US legislation, this plan may in future be referred to as a ‘Risk Evaluation and Mitigation Strategy’ (REMS)

References

  1. Guidance for industry: premarketing risk assessment, March 2005 [online]. Available from URL: http://www.fda.gov/cder/guidance/6357fnl.htm [Accessed 2008 Jan 20]

  2. Guidance for industry: good pharmacovigilance practices and pharmacoepidemiologic assessment, March 2005 [online]. Available from URL: http://www.fda.gov/cder/guidance/6359OCC.htm [Accessed 2008 Jan 20]

  3. Guidance for industry: development and use of risk minimization action plans, March 2005[online]. Available from URL: http://www.fda.gov/cder/guidance/6358fnl.htm [Accessed 2008 Jan 20]

  4. Guideline on risk management systems for medicinal products for human use, 14 November 2005 [online]. Available from URL: http://www.emea.europa.eu/pdfs/human/euleg/9626805en.pdf [Accessed 2008 Jan 20]

  5. Innovative drug development approaches (EMEA/127318/ 2007): final report of the EMEA/CHMP think-tank on innovative drug development, 22 March 2007 [online]. Available from URL: http://www.emea.europa.eu/pdfs/human/itf/12731807en.pdf [Accessed 2008 Jan 20]

  6. The importance of pharmacovigilance: safety monitoring of medicinal products, 2002 [online]. Available from URL: http://www.who.int/medicinedocs/collect/medicinedocs/pdf/s4893e/s4893e.pdf [Accessed 2008 Jan 20]

  7. ICH harmonised tripartite guideline: pharmacovigilance planning (E2E), 18 November 2004 [online]. Available from URL: http://www.ich.org/LOB/media/MEDIA1195.pdf [Accessed 2008 Jan 20]

  8. Waller P. Risk management planning: time to deliver. Pharmacoepidemiol Drug Saf 2006; 15(12): 850–1

    Article  Google Scholar 

  9. Aronson JK. Adverse drug reactions: no farewell to harms. Br J Clin Pharmacol 2007 Feb; 63(2): 131–5

    Article  PubMed  Google Scholar 

  10. Atuah KN, Hughes D, Pirmohamed M. Clinical pharmacology: special safety considerations in drug development and pharmacovigilance. Drug Saf 2004; 27(8): 535–54

    Article  PubMed  CAS  Google Scholar 

  11. Franconi F, Brunelleschi S, Steardo L, et al. Gender differences in drug responses. Pharmacol Res 2007 Feb; 55(2): 81–95

    Article  PubMed  CAS  Google Scholar 

  12. Choquet-Kastylevsky G, Vial T, Descotes J. Allergic adverse reactions to sulfonamides. Curr Allergy Asthma Rep 2002 Jan; 2(1): 16–25

    Article  PubMed  Google Scholar 

  13. Farahani P, Levine M. Pharmacovigilance in a genomic era. Pharmacogenomics J 2006 May; 6(3): 158–61

    Article  PubMed  CAS  Google Scholar 

  14. Mhlongo SW, Mbokazi AJ. Ethnic differences in risks of adverse reactions: biomédical approach is insufficient to explain ethnic differences. BMJ 2006 Jun 10; 332(7554): 1393

    Article  PubMed  Google Scholar 

  15. Osterborg A, Karlsson C, Lundin J, et al. Strategies in the management of alemtuzumab-related side effects. Semin Oncol 2006 Apr; 33 (2 Suppl. 5): S29–35

    Article  PubMed  Google Scholar 

  16. Jordan K, Schmoll HJ, Aapro MS. Comparative activity of antiemetic drugs. Crit Rev Oncol Hematol 2007 Feb; 61(2): 162–75

    Article  PubMed  Google Scholar 

  17. Coleman JJ, Ferner RE, Evans SJ. Monitoring for adverse drug reactions. Br J Clin Pharmacol 2006 Apr; 61(4): 371–8

    Article  PubMed  CAS  Google Scholar 

  18. Statistical analysis of safety data in clinical trials: management of safety information from clinical trials. Report of CIOMS Working Group VI. Geneva: CIOMS, 2005: 131–64

  19. Ferner RE, Coleman J, Pirmohamed M, et al. The quality of information on monitoring for haematological adverse drug reactions. Br J Clin Pharmacol 2005 Oct; 60(4): 448–51

    Article  PubMed  CAS  Google Scholar 

  20. Seligman PJ. Thinking outside the (black) box: a new research agenda. Pharmacoepidemiol Drug Saf 2006 Jun; 15(6): 387–9

    Article  PubMed  Google Scholar 

  21. Ferner RE, Aronson JK. Communicating information about drug safety. BMJ 2006 Jul 15; 333(7559): 143–5

    Article  PubMed  CAS  Google Scholar 

  22. Waller PC, Evans SJ. A model for the future conduct of pharmacovigilance. Pharmacoepidemiol Drug Saf 2003 Jan; 12(1): 17–29

    Article  PubMed  Google Scholar 

  23. Aronson JK. A prescription for better prescribing. Br J Clin Pharmacol 2006 May; 61(5): 487–91

    Article  PubMed  CAS  Google Scholar 

  24. Hallas J. Drug utilization statistics for individual-level pharmacy dispensing data. Pharmacoepidemiol Drug Saf 2005 Jul; 14(7): 455–63

    Article  PubMed  Google Scholar 

  25. Berard A, Azoulay L, Koren G, et al. Isotretinoin, pregnancies, abortions and birth defects: a population-based perspective. Br J Clin Pharmacol 2007 Feb; 63(2): 196–205

    Article  PubMed  Google Scholar 

  26. Stuve O, Marra CM, Cravens PD, et al. Potential risk of progressive multifocal leukoencephalopathy with natalizumab therapy: possible interventions. Arch Neurol 2007 Feb; 64(2): 169–76

    Article  PubMed  Google Scholar 

  27. Nurse J, Edmondson-Jones P. A framework for the delivery of public health: an ecological approach. J Epidemiol Community Health 2007 Jun; 61(6): 555–8

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

No sources of funding were used to assist in the preparation of this review, and the author has no conflicts of interest that are directly relevant to the content of this review.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Torbjőrn Callréus.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Callréus, T. On Pharmaceutical Risk Minimization. Drug-Safety 31, 737–742 (2008). https://doi.org/10.2165/00002018-200831090-00002

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00002018-200831090-00002

Keywords

Navigation