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In vitroTox - Cerep

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ADR panel<br />

Table 2. List of serious ADR drug for 6 organ systems<br />

CNS<br />

Asthenia<br />

Ataxia<br />

Cholinergic toxicity<br />

Coma<br />

Confusion<br />

Convulsion<br />

Depression<br />

Emesis<br />

Extrapyramidal symptoms<br />

Hyperpyrexia<br />

Hypomotility<br />

Nausea<br />

Neuroleptic malignant<br />

syndrome<br />

Neurotoxicity neuropathy<br />

Parkinsonism<br />

Sedation<br />

Seizures<br />

Tardive dyskinesia<br />

Tremors<br />

Vertigo<br />

CV<br />

Atrioventricular block<br />

Bradycardia<br />

Cardiac arrest<br />

Cardiac failure<br />

Cerebrovascular dysfunction<br />

Congestive heart failure<br />

Coronary vascular damage<br />

Dysrhythmias<br />

Heart block<br />

Hypertension<br />

Hypotension<br />

Ischemia<br />

Myocardial damage<br />

Myocardial infarction<br />

Sudden cardiac death<br />

Tachycardia<br />

Torsade de pointes<br />

Vasoconstriction<br />

Ventricular arrhythmias<br />

LIVER<br />

LUNG<br />

Cholestasis<br />

Hepatic and hepatobiliary<br />

disorders<br />

Hepatitis<br />

Hepatocellular damage<br />

Hepatopulmonary syndrome<br />

Hepatotoxicity<br />

Jaundice<br />

Airway hyperreactivity<br />

Bronchial disorders<br />

Fibrosis<br />

Granulocyte infiltration<br />

<strong>In</strong>terstitial pneumonia<br />

Thromboembolism<br />

Vascular pulmonary disorders<br />

BLOOD<br />

KIDNEY<br />

Anemia<br />

Azotemia<br />

Bilirubinemia<br />

Blood autoimmune disorders<br />

Blood dyscrasia<br />

Hematuria<br />

Hemolytic anemia<br />

Hyperbilirubinaemia<br />

Neutropenia<br />

Peripheral ischemia<br />

Platelet aggregation<br />

Porphyria<br />

Red blood cell disorder<br />

Uremia<br />

Diabetic complications<br />

Kidney failure<br />

Nephrotoxicity<br />

Protein present in urine<br />

Renal dysfunction<br />

Urinary tract disorder<br />

Panel Design<br />

➥ Known association of individual targets with serious ADRs<br />

l ADR Databases: DART 1&2 and DITOP 3&4 – Identification of targets already known to be linked to specific ADRs<br />

l Literature – Assay selection based on literature reviewing the mechanisms of action for individual ADRs<br />

➥ Statistical association of individual targets with serious ADRs using information from <strong>Cerep</strong>’s proprietary BioPrint ® Database<br />

l Using BioPrint ® , targets are selected based on statistical associations between individual targets and individual ADRs.<br />

Chi-square analysis was performed to identify statistically significant correlations in a matrix of >150 assays by >800 ADR terms 5 .<br />

Over 5,000 significant in vitro assay-ADR associations were found covering over 100 assays. Close examination of this set of<br />

associations yields many results that are consistent with known pharmacology and many others that appear to be novel.<br />

Figure 2. M3 and “abnormal visual accommodation”<br />

IC 50<br />

BinRange (nM) / BinHits<br />

ADR negative ADR positive Baseline<br />

0 to 99 (n=26)<br />

100 to 499 (n=14)<br />

500 to 999 (n=14)<br />

1,000 to 4,999 (n=32)<br />

5,000 to 9,999 (n=22)<br />

10,000 to 49,999 (n=41)<br />

50,000+ (n=894)<br />

-100 -75 -50 -25 0 25 50 75 100<br />

Percentage of hits<br />

Figure 2 shows the significant statistical association between<br />

in vitro binding to the M3 muscarinic receptor and<br />

the in vivo ADR “abnormal visual accommodation”. Seven<br />

IC 50 activity bins are found on the y-axis ranging from the<br />

0-99 nM bin to the greater-than-50,000 nM bin which is<br />

the default bin for the non-hits. The number of compounds<br />

in each bin is indicated. The blue and red bars shown with<br />

each bin represent the percentage of compounds in that<br />

bin that are positive (blue) or negative (red) for the ADR in<br />

question. This figure illustrates the association of “abnormal<br />

visual accommodation” with the M3 muscarinic receptor.<br />

The baseline frequency of this ADR is 6.44% while nearly<br />

half of the drugs with M3 hits in the

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