Understanding the role of chronopharmacology for drug optimization: what do we know?

ABSTRACT

Introduction

Circadian rhythm influences the pharmacokinetics and pharmacodynamics of a number of drugs and affects their therapeutic efficacy and toxicity depending on the time of day they are administered. Chronopharmacology is a method for incorporating knowledge about circadian rhythm into pharmacotherapy. Chronotherapy, which is the clinical application of chronopharmacology, is particularly relevant when the risk and/or severity of symptoms of a disease change in a predictable manner over time. Chronotherapy has potential benefits in the treatment of many diseases.

Areas covered

Although a considerable amount of knowledge about chronopharmacology and chronotherapy has been accumulated, its therapeutic application in clinical practice remains limited in terms of therapy optimization. Resolution of these issues will improve our ability to deliver adequate drug treatment.

Expert opinion

We propose four approaches for promoting chronotherapy-based drug treatment in clinical practice: targeting drug development and regulatory authorities; education about chronotherapy; drug information for both health professionals and consumers; and a chronotherapy network.

KEYWORDS:

• circadian rhythm
• chronopharmacology
• chronotherapy
• clinical practice
• pharmacokinetics

Article highlights

• Chronopharmacology is an approach that allows knowledge about circadian rhythm to be incorporated into pharmacotherapy. Chronotherapy, which is the clinical application of chronopharmacology, could be beneficial in the treatment of many diseases.

• The influence of circadian rhythm on drug disposition is described and examples of chronotherapy in clinical practice are provided.

• We propose four approaches for promoting chronotherapy-based drug treatment in clinical practice.

Acknowledgments

We thank Edanz (https://jp.edanz.com/ac) for editing a draft of this manuscript.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose

Additional information

Funding

This paper was not funded.