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Prof. Dr. med.
Antonios Douros

antonios.douros@charite.de

Associate Professor of Pharmacoepidemiology
Institute of Clinical Pharmacology and Toxicology
Charité – Universitätsmedizin Berlin


         
Charité Berlin    DFG

Welcome

 

I am an Associate Professor at the Institute of Clinical Pharmacology and Toxicology at Charité in Berlin and Head of the newly-established Douros Lab. The research in our lab focuses on the effectiveness and safety of medications in vulnerable populations, including patients with chronic liver disease, older adults, as well as patients subjected to polypharmacy and at risk of drug-drug interactions. Given the underrepresentation of such populations in randomized controlled trials, our lab aims to provide much needed evidence on the benefit-risk profile of drugs.

For the implementation of our research program, we conduct both hypothesis-generating and hypothesis-testing studies. To this end, we use multiple data sources including spontaneous reports from the FDA Adverse Event Reporting System, German and Canadian administrative healthcare data, and electronic medical records from the United Kingdom. We also collaborate with several experts in the area of real world evidence in Canada, Germany, and Greece. The research in our lab is supported by the German Research Foundation and the Canadian Institutes of Health Research.

Interests

  • Pharmacoepidemiology
  • Pharmacovigilance
  • Clinical Pharmacology
  • Drug-drug interactions
  • Vulnerable populations

Education

  • Postdoc in Pharmacoepidemiology, McGill University
  • Doctorate Degree (Dr. med.), Charité – Universitätsmedizin Berlin
  • Medical Degree, Charité – Universitätsmedizin Berlin

Experience

  • 2023 – present  Associate Professor (Heisenberg)
    Institute of Clinical Pharmacology and Toxicology, Charité – Universitätsmedizin Berlin
  • 2023 – present  Adjunct Professor
    Department of Epidemiology, Biostatistics, and Occupational Health, McGill University
  • 2023 – present  Adjunct Professor
    School of Epidemiology and Public Health, University of Ottawa
  • 2019 – 2023  Assistant Professor
    Department of Medicine (Division Clinical Epidemiology), McGill University
  • 2019 – 2023  Investigator
    Centre for Clinical Epidemiology (Pharmacoepidemiology Research Unit), Lady Davis Institute for Medical Research
  • 2019 – 2023  Associate Member
    Department of Epidemiology, Biostatistics, and Occupational Health, McGill University
  • 2016 – 2018  Postdoctoral Research Fellow
    Centre for Clinical Epidemiology (Pharmacoepidemiology Research Unit), Lady Davis Institute for Medical Research
  • 2014 – 2015  Research Fellow
    Department of Clinical Epidemiology, Leibniz Institute for Prevention Research and Epidemiology – BIPS
  • 2012 – 2016  Clinical Pharmacology Resident
    Institute of Clinical Pharmacology and Toxicology, Charité – Universitätsmedizin Berlin
  • 2009 – 2011  Neurology Resident
    Department of Early Neurological Rehabilitation & Intensive Care Unit, Medical Park Berlin Humboldtmühle

Recent and Upcoming Talks

  • Jun 1, 2024 Repurposing antihypertensive drugs for MAFLD/NAFLD
    33. European Meeting on Hypertension and Cardiovascular Protection
    European Society of Hypertension, Berlin, DE
  • Apr 15, 2024 Break on through to the other side: from pharmacology to RWE
    Mid-Year Meeting, International Society for Pharmacoepidemiology
    Orlando, FL
  • Mar 15, 2024 Time-varying exposure definition in studying drug-drug interactions
    Drug-Drug Interactions Special Interest Group Webinar
    International Society for Pharmacoepidemiology
  • Sep 12, 2023 Assessing the clinical effects of drug-drug interactions using cohort designs
    Therapeutics Research and Infectious Disease Epidemiology, Department of Population Medicine,
    Harvard Medical School, Boston, MA

Publications

You can check out my complete list of publications on PubMed.

To date, my research has resulted in 78 peer-reviewed publications (36 as first author, 14 as senior author). Several of these publications have appeared in top-tier journals including the British Medical Journal (4x), Annals of Internal Medicine, European Heart Journal, Journal of the American College of Cardiology, Diabetes Care (7x), Alzheimer’s & Dementia, JACC: Heart Failure, and Neurology. Moreover, my publications have been the subject of 10 editorials.

Below are a few highlights of my published work.

Forest plot NOAC and Liver Injury
Forest plot NOAC and Liver Injury

Real-world effects of direct oral anticoagulants

Direct oral anticoagulants (DOACs) are blood thinners that are used to prevent and treat thrombotic disease. The most common indications include non-valvular atrial fibrillation (NVAF) and venous thromboembolism (VTE). During my work at McGill University, I studied the utilization of DOACs in patients with NVAF and patients with NVAF and underlying liver disease. I also addressed important safety concerns related to the use of DOACs. I assessed their risk of liver injury (see also Graphical Abstract), thereby showing that DOACs do not increase the risk of this potentially fatal adverse effect when compared to the therapeutic alternative vitamin K antagonists. These findings provided reassurance regarding the hepatic safety of DOACs. I also studied their risk of esophageal disorders, and their risk of major bleeding when used together with antiplatelet agents in patients with NVAF and in patients with VTE. Moreover, I assessed the effectiveness and safety of DOACs in high-risk populations such as patients with NVAF and underlying liver disease, octogenarians with VTE and patients with cancer related thrombosis.

Infographic Sulfonylureas
Infographic Sulfonylureas

Safety of sulfonylureas

Sulfonylureas are oral antidiabetic drugs commonly used in the management of type 2 diabetes. They are efficacious in controlling blood glucose levels; however, there are concerns regarding their cardiovascular and hypoglycemic safety. I studied the safety of sulfonylureas, both as first-line treatments and second-line treatments. I also specifically studied the safety of glimepiride, a sulfonylurea often used as active comparator in randomized controlled trials assessing the effects of newer antidiabetic drugs. Recently, several studies funded by the Canadian Institutes of Health Research and led by my trainee Jenny Dimakos focused on the risk of severe hypoglycemia due to concomitant use of sulfonylureas and warfarin, beta-blockers (see also Graphical Abstract) and dipeptidyl peptidase-4 inhibitors. Overall, this work has advanced our understanding regarding the overall safety of profile of these commonly used antidiabetic drugs.

Infographic Sodium-glucose co-transporter 2 inhibitors
Infographic Sodium-glucose co-transporter 2 inhibitors

Safety of sodium-glucose co-transporter 2 inhibitors

Sodium-glucose co-transporter 2 (SGLT2) inhibitors are a newer class of oral antidiabetic drugs used in the management of type 2 diabetes and other cardiometabolic conditions. In 2020, I was selected to lead an international, multicenter study on their safety. The study was conducted by the Canadian Network for Observational Drug Effect Studies (CNODES), one of the largest pharmacoepidemiologic networks in the world. The aim was to assess the risk of diabetic ketoacidosis with SGLT2 inhibitors, an important safety concern according to several regulatory agencies. We observed an almost 3-fold increased risk of this potentially fatal adverse effect with SGLT2 inhibitors (see also Graphical Abstract). Outside of CNODES, I have also studied their risk of VTE as part of our collaboration with the InGef – Institut für angewandte Gesundheitsforschung Berlin and the safety of their interaction with statins as part of our collaborations with the University of Ottawa and and the Democritus University of Thrace.

Grants, Awards & Distinctions

Research Grants as PI

  • 2019-2023 Project Grant (CAD 225,676.00)
    Canadian Institutes of Health Research
    Effectiveness and safety of direct oral anticoagulants in patients with non-valvular atrial fibrillation and liver disease
  • 2019-2022 Project Grant (CAD 149,176.00)
    Canadian Institutes of Health Research
    Concomitant use of sulfonylureas with warfarin and the risk of severe hypoglycemia in patients with type 2 diabetes

Personal Salary Awards

  • 2023-2028 Heisenberg Program (EUR 630,000.00)
    German Research Foundation
    Effectiveness and safety of medications in vulnerable populations
  • 2020-2023 Junior 1 Salary Support Award (CAD 364,901.00)
    Fonds de recherche du Québec – Santé
    Efficacité et innocuité des médicaments dans les populations vulnérables
  • 2016-2018 Research Fellowship (EUR 122,626.00)
    German Research Foundation
    Comparative effectiveness and safety of non-vitamin K antagonist oral anticoagulants in stroke prevention in atrial fibrillation

Other Personal Awards

  • 2022 Excellence in Teaching Epidemiology (2021-2022)
    Epidemiology, Biostatistics and Occupational Health Student Society, McGill Department of Epidemiology, Biostatistics and Occupational Health
  • 2022 Travel Grant
    European Renal Association
  • 2021 Comparative Effectiveness Research Special Interest Group Spotlight Poster Award
    International Society for Pharmacoepidemiology
  • 2018 Second Best Abstract by a Student/ Postdoc
    International Society for Pharmacoepidemiology

Distinctions

  • 2023 Appointment as Full Member
    Canadian Institutes of Health Research College of Reviewers
  • 2022 Appointment as Associate Member
    Canadian Institutes of Health Research College of Reviewers
  • 2023 Paper of the Month
    Lady Davis Institute for Medical Research, Apr 2023
  • 2019 Paper of the Month
    Lady Davis Institute for Medical Research, Jul 2019
  • 2019 Paper of the Quarter
    Charité Institute of Biometry and Clinical Epidemiology, Apr 2019
  • 2018 Paper of the Month
    Lady Davis Institute for Medical Research, Jul 2018
  • 2022 Best Reviewer Annals of Internal Medicine
  • 2019 Best Reviewer Annals of Internal Medicine
  • 2019 Best Reviewer Pharmacoepidemiology and Drug Safety
  • 2018 Best Reviewer Pharmacoepidemiology and Drug Safety
  • 2015 Best Reviewer Pharmacoepidemiology and Drug Safety