Drugs‐associated with red man syndrome: An integrative approach using disproportionality analysis and Pharmip

alexandrossfakianakis shared this article with you from Inoreader Drugs‐associated with red man syndrome: An integrative approach using disproportionality analysis and Pharmip via Journal of Clinical Pharmacy and Therapeutics We performed a retrospective disproportionality analysis exploiting FAERS database and unveiled drugs associated with Red man syndrome. Further, a novel in silico technique of PHARMIP was used followed by molecular docking to signify the role of Carbonic anhydrase II and MRGPRX2 in causing the event. Corroborating the drugs causing the adverse event with the genes revealed Oritavancin to have the highest affinity. This indicated the potentiality of this drug to cause Red man syndrome. Abstract What is known and objective Red man syndrome (RMS) is a non-IgE-mediated anaphylactoid adverse event frequently witnessed after a rapid infusion of vancomycin. This study aims to unravel drugs and associated off-label targets that induce RMS by exploiting FDA Adverse Event Reporting System (FAERS) and Pharmacovigilance/Pharmacogenomics Insilico Pipeline (PHARMIP). Methods The case/non-case retrospective observational study was conducted in the FAERS database. Reporting odds ratio (ROR) and proportional reporting ratio (PRR) data mining algorithms were used to evaluate the strength of the signal. The off-label targets of the drugs with potential signals were obtained using online servers by applying a similarity ensemble approach and a reverse pharmacophore database, which was further validated by molecular docking studies. Results and discussion Oritavancin exhibited a strong positive signal (PRR:1185.20 and ROR:1256), which suggests a higher risk for causing RMS. The literature search revealed the involvement of the MRGPRX2 gene in the development of RMS. PHARMIP study unearthed Carbonic anhydrase II (CA2) as the common off-label target among the drugs causing RMS. The results obtained from molecular docking studies reinforced the findings as mentioned earlier, wherein the highest docking score was disinterred for oritavancin (−9.4 for MRGPRX2 and − 8.7 for CA2). What is new and conclusion Many antibiotics and other classes of medications have been discovered in the quest for drugs that may induce RMS, although a causal relationship could not be established. The implication of MRGPX2 and CA2 in the initial stages of pathogenesis necessitates the development of inhibitors that could be used as potential therapeutic agents against RMS. View on Web

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