This article is more than 5 years old. Information may no longer be current.
Pharmacogenetic findings for CV drugs compiled for use in clinical practice
Click Here to Manage Email Alerts
Researchers have found clinically actionable pharmacogenetic information for 51 CV drugs and compiled recommendations for use in clinical practice.
Between January 2011 and May 2013, they assessed 71 CV drugs by identifying all pairings of drugs and genetic variants with published clinical pharmacogenetic evidence. For 51 of the 71 drugs (71.8%), at least one variant was identified in the literature as being associated with increased risk for adverse events as a result of taking the drug and/or increased odds of low or nonresponse.
“Tens of thousands of patients have been studied and the connections between common medications and the genetic variants that can lead to adverse drug reactions or treatment nonresponse have been described, but few physicians track this information or even know where to find it,” Peter H. O’Donnell, MD, assistant professor of medicine at the University of Chicago, said in a press release. “One dose does not fit all. So we set out to boost awareness and simplify access.” They published their findings in Mayo Clinic Proceedings.
O’Donnell and colleagues assessed the literature for each drug/variant pair and scored them according to a modified form of the Appraisal of Guidelines for Research and Evaluation (AGREE) II instrument. Based on the AGREE II score, they recommended for or against guideline implementation for each pair.
They found positive pharmacogenetic findings for 884 unique drug/variant pairs from 597 publications, and recommended 92 pairs, encompassing 23 drugs, for translation into clinical summaries (mean AGREE II overall quality score, 5.18; range, 3.67-7).
The following drug/variant pairs received the highest scores:
- clopidogrel/CYP2C19;
- metoprolol/CYP2D6;
- simvastatin/rs4149056;
- dabigatran (Pradaxa, Boehringer Ingelheim)/rs2244613;
- hydralazine/rs1799983 and rs1799998; and
- warfarin/CYP2C9 and VKORC1.
Seven of the nine most commonly prescribed CV drugs in the United States were recommended for inclusion of pharmacogenetic information in guidelines. They are amlodipine, atenolol, atorvastatin, hydrocholorothiazide, metoprolol, simvastatin and warfarin.
“There is substantial pharmacogenomic information on [CV] drugs that could potentially be applied to patient care,” the researchers wrote. “Given the burden of [CVD] and the potential of personalized medicine, this information merits being made available for clinical implementation in a research context to determine whether it affects physician decision-making and patient outcomes.” – by Erik Swain
Disclosure: O’Donnell and two other researchers report being named as co-inventors on a pending patent for the Genomic Prescribing System. One researcher reports holding patents related to pharmacogenetic diagnostics and receiving royalties related to UGTIAI genotyping. Another reports being a founder of, stockholder of and consultant to Personalis Inc.
Click Here to Manage Email Alerts