Details of a Researcher - AKAMINE Yumiko

BACKGROUND: Voriconazole (VRCZ) is an effective treatment for pulmonary aspergillosis. Active infectious disease leads to a reduction in cytochrome P450 activity, resulting in increased VRCZ concentrations. However, the impact of VRCZ dose reduction during the severe inflammatory state on VRCZ concentrations after the resolution of inflammation is not yet fully understood. Here, we report the time-course changes in VRCZ blood concentrations after inflammation in a patient with invasive pulmonary aspergillosis. CASE PRESENTATION: A man in his 60s receiving oral VRCZ tablets at 400 mg/day for invasive pulmonary aspergillosis developed marked inflammation due to bacterial pneumonia and influenza virus infection. C-reactive protein (CRP) levels increased to a peak of 35.54 mg/dL, with a concomitant elevation in the VRCZ trough concentration to 4.7 µg/mL. Following dose reduction to VRCZ 300 mg/day, the trough concentration decreased to 1.1 µg/mL on day 11 after dose reduction, while CRP declined to 4.78 mg/dL after antibiotic therapy. VRCZ was continued at the same dose. However, four weeks after CRP levels had stabilized, the VRCZ concentration decreased to 0.6 µg/mL. After re-escalation of VRCZ to 400 mg/day, the trough concentration returned to the effective therapeutic range of 1.1 µg/mL. CONCLUSIONS: After infection is controlled, VRCZ concentrations may decrease to levels below the therapeutic range. Following VRCZ dose reduction during a high inflammatory state, reassessment of trough concentrations after improvement of inflammation may be useful to prevent excessive decreases in VRCZ concentrations.

DOI PubMed

Relationship of nutritional or systemic inflammatory markers with efficacy of gemcitabine and cisplatin with or without durvalumab therapy for patients with unresectable or metastatic biliary tract cancer: a retrospective study.

Yayoi Fukushi, Kazuma Fujita, Yumiko Akamine, Haruka Igarashi, Katsuya Sasaki, Koji Fukuda, Hiroyuki Shibata, Masafumi Kikuchi

Journal of pharmaceutical health care and sciences ( Journal of Pharmaceutical Health Care and Sciences ) 12 ( 1 ) 2026.02

Research paper (journal)

DOI PubMed

Influence of pharmacokinetics-related polymorphisms on asciminib exposure in patients with Japanese chronic myeloid leukemia.

Naoto Takahashi, Yumiko Akamine, Masatomo Miura

European journal of clinical pharmacology ( European Journal of Clinical Pharmacology ) 82 ( 2 ) 49 - 49 2026.01

Research paper (journal)

PURPOSE: The effects of polymorphisms in CYP3A4, UGT2B7, ABCB1, ABCG2, ABCC2, NR1I2, and AHR genes on asciminib exposure were evaluated in Japanese patients with chronic myeloid leukemia. METHODS: Plasma concentrations of asciminib (40 mg twice daily [BID] or 80 mg once daily [QD]) were measured by high-performance liquid chromatography. Statistical analysis was performed using SPSS (P < 0.05). RESULTS: For both regimens, the median asciminib area under the concentration-time curve (AUC) was significantly higher in female than in male patients (P = 0.009 and 0.004, respectively). Significant correlations were observed between the asciminib AUC of 40 mg BID or 80 mg QD and body weight (P = 0.042 and < 0.001, respectively). The asciminib AUC0-12 of 40 mg BID in patients with the -25385 T allele of the NR1I2 -25385C > T polymorphism was significantly lower than that in patients with the -25385C/C genotype (5363 and 10607 ng∙h/mL, respectively, P = 0.001). In multiple regression analyses, the NR1I2 -25385C > T polymorphism (P = 0.001) and female sex (P = 0.002) were independently predictive of a higher asciminib AUC0-12 for the 40 mg BID regimen (determination coefficient: 52.8%), whereas body weight (P < 0.001) and female sex (P = 0.047) were independently predictive of a higher asciminib AUC0-24 for the 80 mg QD regimen (determination coefficient: 52.2%). CONCLUSION: Overall, our findings showed that an adjustment of the initial asciminib dose may be needed based on genotyping information for the NR1I2 -25385C > T polymorphism and the body weight of the patient; however, further prospective studies are necessary.

DOI PubMed

Drug Interaction Between Erlotinib and Itraconazole in a Patient With Non-Small Cell Lung Cancer.

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

Case reports in oncological medicine 2026 7788444 - 7788444 2026

Research paper (journal)

INTRODUCTION: Erlotinib (ERL) is metabolized primarily by cytochrome P450 (CYP) 3A4. We report a case of non-small cell lung cancer in which plasma ERL concentrations increased following coadministration of itraconazole (ITCZ). CASE PRESENTATION: In this patient, a 67-year-old man receiving ERL 150 mg/day, the trough plasma concentration (C 0) of ERL and its major metabolite, O-desmethyl ERL (OSI-420), increased following coadministration of ITCZ. The total clearance of ERL at steady state was 6.1 L/h. The mean C 0 of ERL and OSI-420 were 437 and 47.1 ng/mL, respectively, and the C 0 ratio of OSI-420/ERL was 0.108. With coadministration of oral ITCZ (200 mg/day capsule), the mean C 0 of ERL and OSI-420 increased to 1124 and 166 ng/mL, respectively, and the mean C 0 ratio of OSI-420/ERL increased to 0.147. The mean C 0 of ITCZ and the sum of ITCZ and the active metabolite hydroxyitraconazole (OH-ITCZ) were 109 and 271 ng/mL, respectively. The mean C 0 of ERL increased approximately 2.5-fold. CONCLUSION: Even at the relatively lower C 0 of ITCZ (compared with the recommended target value), ITCZ coadministration increased the C 0 of ERL. In patients with a sufficient ERL C 0 of more than 500 ng/mL prior to ITCZ coadministration or patients exhibiting adequate absorption of oral ITCZ, the risk of ERL-related adverse events with ITCZ coadministration may increase due to further elevation of the ERL C 0. Therefore, when ERL is coadministered with ITCZ, careful monitoring for adverse effects and appropriate dose adjustments are required, considering potential changes in ERL concentrations. Management using the C 0 of ERL and ITCZ may be necessary.

DOI PubMed

Efficacy of Switching to Levetiracetam After S-1-Induced Phenytoin Concentration Increase: A Case Report.

Hayato Yokota, Haruka Igarashi, Yumiko Akamine, Shinichiro Atsumi, Akise Umakoshi, Masafumi Kikuchi

Cureus 17 ( 4 ) e82653 2025.04

Research paper (journal)

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

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An update on the clinical pharmacokinetics of fexofenadine enantiomers.

Akamine Y and Miura M.

Expert Opinion on Drug Metabolism & Toxicology ( Taylor and Francis Group ) 2018.04

Introduction and explanation (scientific journal) Domestic Co-author

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Development of a High-Performance Liquid Chromatography Assay Using Relative Molar Sensitivity for the Simultaneous Quantification of Clozapine and <i>N</i>-Desmethylclozapine Concentrations in Human Plasma

Akamine Yumiko, Ohtsuki Takashi, Matsushita Miyuki, Matsufuji Hiroshi, Morikawa Satoru, Miura Masatomo

Iryo Yakugaku (Japanese Journal of Pharmaceutical Health Care and Sciences) ( Japanese Society of Pharmaceutical Health Care and Sciences ) 52 ( 6 ) 324 - 335 2026.06

DOI CiNii Research

Drug-induced obesity: Focus on antipsychotic medications for schizophrenia

赤嶺由美子

肥満研究 32 ( 1 ) 36 - 41 2026

CiNii Research J-GLOBAL

Comprehensive clinical laboratory analysis of the Japanese Kampo medicine “Gorei-san′′ reveals a potential antihypertensive effect supported by aquaporin-related mechanisms

阿部史葉, 阿部史葉, 佐藤(沼田)かお理, 赤嶺由美子, 沼田朋大

日本薬学会年会要旨集(Web) 146th 2026

J-GLOBAL

The impact of NR1I2 gene polymorphism and body weight on asciminib pharmacokinetics in patients with chronic myeloid leukemia

Naoto Takahashi, Yumiko Akamine, Masatomo Miura

BLOOD 146 2025.11

Summary of the papers read (international conference)

DOI

Therapeutic strategies for psychotropics utilizing blood drug concentrations: a practical approach by pharmacists

赤嶺由美子

日本薬学会年会要旨集(Web) 145th 2025

J-GLOBAL