RxNorm for drug name normalization: a case study of prescription opioids in the FDA adverse events reporting system

Huyen Le; Ru Chen; Stephen Harris; Hong Fang; Beverly Lyn-Cook; Huixiao Hong; Weigong Ge; Paul Rogers; Weida Tong; Wen Zou

doi:10.3389/fbinf.2023.1328613

RxNorm for drug name normalization: a case study of prescription opioids in the FDA adverse events reporting system

Front Bioinform. 2024 Jan 5:3:1328613. doi: 10.3389/fbinf.2023.1328613. eCollection 2023.

Authors

Huyen Le¹, Ru Chen², Stephen Harris¹, Hong Fang³, Beverly Lyn-Cook⁴, Huixiao Hong¹, Weigong Ge¹, Paul Rogers¹, Weida Tong¹, Wen Zou¹

Affiliations

¹ Division of Bioinformatics and Biostatistics, Jefferson, AR, United States.
² Office of Translational Science, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, United States.
³ Office of Scientific Coordination, Jefferson, AR, United States.
⁴ Division of Biochemistry Toxicity, National Center for Toxicological Research, U.S. Food and Drug Administration, Jefferson, AR, United States.

Abstract

Numerous studies have been conducted on the US Food and Drug Administration (FDA) Adverse Events Reporting System (FAERS) database to assess post-marketing reporting rates for drug safety review and risk assessment. However, the drug names in the adverse event (AE) reports from FAERS were heterogeneous due to a lack of uniformity of information submitted mandatorily by pharmaceutical companies and voluntarily by patients, healthcare professionals, and the public. Studies using FAERS and other spontaneous reporting AEs database without drug name normalization may encounter incomplete collection of AE reports from non-standard drug names and the accuracies of the results might be impacted. In this study, we demonstrated applicability of RxNorm, developed by the National Library of Medicine, for drug name normalization in FAERS. Using prescription opioids as a case study, we used RxNorm application program interface (API) to map all FDA-approved prescription opioids described in FAERS AE reports to their equivalent RxNorm Concept Unique Identifiers (RxCUIs) and RxNorm names. The different names of the opioids were then extracted, and their usage frequencies were calculated in collection of more than 14.9 million AE reports for 13 FDA-approved prescription opioid classes, reported over 17 years. The results showed that a significant number of different names were consistently used for opioids in FAERS reports, with 2,086 different names (out of 7,892) used at least three times and 842 different names used at least ten times for each of the 92 RxNorm names of FDA-approved opioids. Our method of using RxNorm API mapping was confirmed to be efficient and accurate and capable of reducing the heterogeneity of prescription opioid names significantly in the AE reports in FAERS; meanwhile, it is expected to have a broad application to different sets of drug names from any database where drug names are diverse and unnormalized. It is expected to be able to automatically standardize and link different representations of the same drugs to build an intact and high-quality database for diverse research, particularly postmarketing data analysis in pharmacovigilance initiatives.

Keywords: FAERS; RxCUI; RxNorm; drug name normalization; drug safety; prescription opioids.

Grants and funding

The author(s) declare financial support was received for the research, authorship, and/or publication of this article. This work and the publication were funded by FDA. HL acknowledges the support of a fellowship from the Oak Ridge Institute for Science and Education, administered through an interagency agreement between the U.S. Department of Energy and the U.S. Food and Drug Administration.