The increasing importance of drug-nutrient interactions

Emerging scientific evidence suggests that micronutrient intake in higher doses holds promise for roles beyond currently recognised health effects for selected individuals and population groups

Increased awareness of the role of vitamins and lipids beyond their nutritional range and their use in the pharmaceutical industry is important for the creation of innovative, safe and high-quality products that will support core therapeutic areas.

To further this understanding, healthcare professionals (HCPs) and scientists require reliable clinical data to increase their knowledge of drug-nutrient interactions (DNIs) on patient health.

What are DNIs?

DNIs are defined as deviations from the normal pharmacokinetics or pharmacodynamics of a drug or nutritional element, or a compromise in nutritional status because of the addition of a drug.1

They arise because drugs and nutrients can share similar mechanisms and pathways. Examples of when DNIs occur include statins, contraceptives and proton pump inhibitors.

Giving DNIs the attention they deserve

Key studies describe the vital role that nutrition can play in clinical conditions and demonstrates the significance of DNIs on health. And, because of the ageing population and prevalence of chronic disease, the role of nutrients in combination with pharmaceuticals has an increasingly important role to play … and is something the industry should explore.

To achieve this, there is an urgent need to increase data and clinical observations of DNIs on a case-by-case basis to help bridge the gap between science and practice.

The latest clinical research

Limited clinical research in the field and acknowledgement of DNIs in the pharmaceutical industry has made it challenging to observe the effects of DNIs in patients. However, several associations have been made between certain drugs and nutrients, shaping future research in this area.

The evolving role of vitamins and lipids as active pharmaceutical ingredients (APIs) to treat chronic disease creates huge potential to bring new therapeutic concepts to market. There is strong scientific evidence that eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) fatty acids may provide health benefits, including better cancer treatment outcomes.2

This was observed in a recent trial, which demonstrated a two-fold increase in therapy response rate and clinical benefit when patients were supplemented with EPA and DHA compared with patients undergoing the same treatment without supplementation.3

Similarly, application of intravenous high-dose vitamin C in cancer patients has been shown to enhance quality of life by improving physical, mental and emotional functions.4

Other notable DNIs involve non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen and naproxen, and certain vitamins or lipids.

One study demonstrated that patients could reduce the dose of NSAIDs when consumed in conjunction with an adequate dose of EPA and DHA, which have proven anti-inflammatory properties, leading to reduced side-effects while still experiencing the clinical benefit of the drug.5

Conclusion

Clinical data on the effects of combining pharmaceuticals with supplements can support the development of safe individualised treatment strategies for patients. However, more investigation into the effects of micronutrient supplementation on health when used in combination with pharmaceuticals is needed.

DSM is currently the only company in the world to hold both US DMFs and CEP certifications for all 13 essential vitamins.

DSM offers its pharmaceutical customers worldwide unparalleled sustainability of supply and speed to market, accelerating the registration process to get products to market faster.

With extensive experience in pharma-grade vitamins, carotenoids and lipid active pharmaceutical ingredients (APIs), DSM provides customers with entirely customised support throughout every stage of a project.

References

  1. L. Hazell, et al., “Under-Reporting of Adverse Drug Reactions: A Systematic Review,” Drug Saf. 29(5), 385–371 (2006).
  2. K. Marshall, et al., “EPA and DHA Omega-3s as a Potential Adjunct to Chemotherapy in the Treatment of Cancer,” Agro FOOD Industry Hi Tech 28(2), 19–22 (2017).
  3. R. Murphy, et al., “Nutritional Intervention with Fish Oil Provides a Benefit Over Standard of Care for Weight and Skeletal Muscle Mass in Patients with Non-Small Cell Lung Cancer Receiving Chemotherapy,” Cancer 117(8), 1775–1178 (2011).
  4. H. Fritz, et al., “Intravenous Vitamin C and Cancer: A Systematic Review,” Integrative Cancer Therapies 13(4), 280–300 (2014).
  5. E.A. Miles, et al., “Influence of Marine n-3 Polyunsaturated Fatty Acids on Immune Function and a Systematic Review of Their Effects on Clinical Outcomes in Rheumatoid Arthritis,” Br. J. Nutr. 107(Suppl. 2), S171–S184 (2012).
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