Details of a Researcher - AKAMINE Yumiko

S-1, an oral anticancer drug, interacts with phenytoin (PHT) to increase PHT serum concentration. Although the PHT dosage is usually adjusted, few studies have examined the effects of switching from PHT to another antiepileptic drug. Here, we report the details of a case in which a patient with gastric cancer continued adjuvant chemotherapy after switching from PHT to levetiracetam (LEV) to prevent interactions with S-1. A man in his 60s with advanced gastric cancer received adjuvant chemotherapy with S-1 120 mg/day (cycles of two weeks of administration followed by one week of rest). He had experienced generalized tonic-clonic seizures 48 years prior and had been taking PHT (170 mg/day) and carbamazepine (250 mg/day). On day 22 of treatment, the PHT concentration increased from 3.72 to 11.76 µg/mL. On day 25, he developed dizziness and fell. Gradual PHT dose reduction and a switch to LEV improved his symptoms, and he remained seizure-free over nine treatment cycles. The findings of this case report suggest an approach for switching from PHT to another antiepileptic drug when PHT levels increase due to interactions with S-1. Switching to LEV may result in fewer interactions.

DOI PubMed

Comparison of Serum Vancomycin Concentrations using a New Automated Analyzer based on High-Performance Liquid Chromatography and Chemiluminescent Immunoassay

Akamine Yumiko, Matsushita Miyuki, Morikawa Satoru, Miura Masatomo

Iryo Yakugaku (Japanese Journal of Pharmaceutical Health Care and Sciences) ( Japanese Society of Pharmaceutical Health Care and Sciences ) 51 ( 4 ) 187 - 195 2025.04

Research paper (journal)

DOI CiNii Research

Effect of isavuconazole on the concentration of tacrolimus in a patient with genotype CYP3A5*1/*3: a case report.

Hayato Yokota, Yumiko Akamine, Harumi Hatakeyama, Hideaki Kagaya, Sho Sakamoto, Mitsuru Saito, Masahide Takeda, Kazuhiro Sato, Katsutoshi Nakayama, Masafumi Kikuchi

Journal of pharmaceutical health care and sciences ( Journal of Pharmaceutical Health Care and Sciences ) 11 ( 1 ) 20 - 20 2025.03

Research paper (journal)

BACKGROUND: Azole antifungals are the standard treatment for pulmonary mycosis, which may develop during long-term immunotherapy for kidney transplant. Isavuconazole (ISCZ) is a cytochrome P450 (CYP) 3 A inhibitor that has a risk of interacting with the immunosuppressive drug tacrolimus (TAC). We report a case of simple pulmonary aspergilloma with renal dysfunction due to increased trough levels of TAC after ISCZ coadministration. CASE PRESENTATION: A male in his 60s was treated with TAC 3.0 mg/day orally to prevent graft rejection after kidney transplantation. He received a loading dose of ISCZ 600 mg/day orally for two days, followed by a maintenance dose of 200 mg/day for simple pulmonary aspergilloma. The TAC trough concentration increased markedly from 2.4 to 9.9 ng/mL on day 6 after coadministration. The creatinine level increased from 0.70 to 1.08 mg/dL, suggesting renal dysfunction due to TAC. Subsequently, the TAC dosage was reduced, leading to a decreased blood TAC concentration and improved renal function. The patient's genotype was CYP3A5*1/*3. CONCLUSIONS: In the early stages of ISCZ treatment, the blood TAC concentration is higher, and CYP3A5 polymorphisms may partially explain the extent of this interaction. We recommend more careful monitoring of TAC and serum creatinine levels for approximately one week after ISCZ administration.

DOI PubMed

Influence of interleukin-6 on the pharmacokinetics and pharmacodynamics of osimertinib in patients with non-small cell lung cancer.

Hayato Yokota, Kazuhiro Sato, Sho Sakamoto, Yuji Okuda, Masahide Takeda, Yumiko Akamine, Katsutoshi Nakayama, Masatomo Miura

Cancer chemotherapy and pharmacology ( Cancer Chemotherapy and Pharmacology ) 95 ( 1 ) 49 - 49 2025.03

Research paper (journal)

PURPOSE: The inflammatory cytokine interleukin (IL)-6 reduces the activity of drug metabolic enzymes and promotes tumor progression. We investigated the effect of IL-6 on the pharmacokinetics of osimertinib and the association between an IL-6 polymorphism and clinical outcomes in 30 patients with non-small cell lung cancer (NSCLC). METHODS: Osimertinib and IL-6 plasma concentrations were measured on day 15 after therapy initiation. The genotype of IL-6 1800796G > C was identified using polymerase chain reaction-restriction fragment length polymorphism. Risk factors affecting overall survival (OS) were assessed by Cox proportional hazard regression analysis. RESULTS: The IL-6 concentration was significantly correlated with the osimertinib trough plasma concentration (r = 0.423, P = 0.020) and area under the plasma concentration-time curve (r = 0.420, P = 0.021). The IL-6 concentration was significantly higher in patients with the IL-6 rs1800796G allele versus C/C genotype (P = 0.024). OS was significantly shorter in patients with the IL-6 rs1800796G allele versus C/C genotype (median: 15.1 vs. 48.9 months, P = 0.005). Univariate and multivariate analyses indicated that the IL-6 rs1800796G allele is an independent risk factor for OS (crude hazard ratio = 7.07; P = 0.014; adjusted hazard ratio = 6.38; P = 0.021). CONCLUSION: A higher IL-6 concentration was associated with reduced metabolic activity of osimertinib, leading to increased osimertinib exposure. As the IL-6 concentration was higher in NSCLC patients with the IL-6 rs1800796G allele, it might be an independent prognostic factor for patients treated with osimertinib.

DOI PubMed

Evaluation of the accuracy of simultaneous determination of plasma concentrations of clozapine and N-desmethylclozapine using the new LM1010 high performance liquid chromatography.

赤嶺由美子, 松下美由紀, 森川悟, 三浦昌朋

臨床精神薬理 28 ( 1 ) 87 - 98 2025.01

Research paper (journal)

J-GLOBAL

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