The 'Orange Card' Initiative: The Search for ‘Tertiary Effects’ of Drugs
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Abstract
Marketed drugs are known to possess both therapeutic (primary) effects and side (secondary) effects. Occasionally, during the course of treating a specific disease, unexpected beneficial outcomes, referred to as "tertiary effects," may emerge. These tertiary effects have shown great potential for drug repurposing, particularly in the context of rare diseases. Unfortunately, the observation of such effects often falls to physicians, nurses, and pharmacists who lack a proper system for effectively communicating these findings to the healthcare community. In this proposal, I suggest the development of an innovative solution called the "Orange Card," which aims to facilitate the reporting of suspected unexpected beneficial effects associated with a particular treatment. This system would leverage the existing well-established framework employed by most countries for reporting side effects, enabling seamless integration and enhancing communication within the healthcare system.
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References
2. Ashburn, T. & Thor, K. Drug repositioning: identifying and developing new uses for existing drugs. Nat Rev Drug Discov 3, 673–683 (2004).
3. Muench, P. J. Happy birthday Viagra. Del Med J 84, 157–159 (2012).
4. Goldstein, I., Burnett, A., Rosen, R., Park, P. & Stecher, V. The serendipitous story of sildenafil: an unexpected oral therapy for erectile dysfunction. Sex Med Rev 7, 115–128 (2019).
5. Baum, J. & Vaughan, J. Immunosuppressive drugs in rheumatoid arthritis. Ann Intern Med 71, 202–204 (1969).
6. Ma, H. et al. Efficacy and safety of GLP-1 receptor agonists versus SGLT-2 inhibitors in overweight/obese patients with or without diabetes mellitus: a systematic review and network meta-analysis. BMJ Open 13, e061807 (2022).
7. Delay, J. & Deniker, P. Neuroleptic effects of chlorpromazine in therapeutics of neuropsychiatry. Int Rec Med Gen Pract Clin 168, 318–326 (1955).
8. Kuhn, R. The treatment of depressive states with G 22355 (imipramine hydrochloride). Am J Psychiatry 115, 459–464 (1958).
9. Frank, S. Tetrabenazine: the first approved drug for the treatment of chorea in US patients with Huntington disease. Neuropsychiatr Dis Treat 6, 657–665 (2010).
10. Evans, W., Gensler, F., Blackwell, B. & Galbrecht, C. The effects of antidepressant drugs on pain relief and mood in the chronically ill. A double-blind study. Psychosomatics 14, 214–219 (1973).
11. Patetsos, E. & Horjales-Araujo, E. Treating chronic pain with SSRIs: what do we know? Pain Res Manag 2016, 2020915 (2016).
12. Storey, J. R., Calder, C. S., Hart, D. E. & Potter, D. L. Topiramate in migraine prevention: a double-blind, placebo-controlled study. Headache 41, 968–975 (2001).
13. Desborough, M. & Keeling, D. The aspirin story-from willow to wonder drug. Br J Haematol 177, 674–683 (2017).
14. Grogan, D. . & Winston, N. . Thalidomide. (StatPearls Publishing LLC., 2023).
15. Hazell, L., Cornelius, V., Hannaford, P., Shakir, S. & Avery, A. J. How do patients contribute to signal detection? : A retrospective analysis of spontaneous reporting of adverse drug reactions in the UK’s Yellow Card Scheme. Drug Saf 36, 199–206 (2013).
16. Van Hunsel, F. & Ekhart, C. Unexpected beneficial effects of drugs: an analysis of cases in the Dutch spontaneous reporting system. Eur J Clin Pharmacol 77, 1543–1551 (2021).
17. Borges, R. We need a global system to help identify new uses for existing drugs. Br Med J 348, g1806 (2014).
18. Asker-Hagelberg, C. et al. Repurposing of Medicines in the EU: Launch of a Pilot Framework. Front Med 8, 817663 (2022).