Department of Pharmacology, JIPMER, Puducherry, India.
Indian J Pharmacol. 2008 Aug;40(4):137-43. doi: 10.4103/0253-7613.43158.
Pharmacogenetics and pharmacogenomics are two major emerging trends in medical sciences, which influence the success of drug development and therapeutics. In current times, though pharmacogenetic studies are being done extensively for research, its application for drug development needs to get started on a large scale. The major determinants of success of a new drug compound, viz safety and efficacy, have become more predictable, with the advent of pharmacogenetic studies. There is a need felt for pharmacogenomic studies, where the effects of multiple genes are assessed with the study of entire genome.Pharmacogenetic studies can be used at various stages of drug development. The effect of drug target polymorphisms on drug response can be assessed and identified. In clinical studies, pharmacogenetic tests can be used for stratification of patients based on their genotype, which corresponds to their metabolizing capacity. This prevents the occurrence of severe adverse drug reactions and helps in better outcome of clinical trials. This can also reduce attrition of drug compounds. Further, the variations in drug response can be better studied with the wider application of pharmacogenomic methods like genome wide scans, haplotype analysis and candidate gene approaches. The cost of pharmacogenetic testing has become very low, with the advent of newer high throughput genotyping systems. However, the cost of pharmacogenomic methods continues to be very high. As the treatment with several drugs is being more and more pharmacogeneticaly guided (e.g. warfarin and irinotecan), the FDA has laid down guidelines for pharmaceutical firms regarding submission of pharmacogenetic data for their drug products in labelling.
药物遗传学和药物基因组学是医学科学中的两个主要新兴趋势,它们影响着药物开发和治疗的成功。尽管目前正在广泛进行药物遗传学研究用于研究,但需要大规模开始将其应用于药物开发。随着药物遗传学研究的出现,新药化合物成功的主要决定因素(即安全性和有效性)变得更加可预测。人们感到需要进行药物基因组学研究,在这种研究中,通过研究整个基因组来评估多个基因的影响。药物遗传学研究可以在药物开发的各个阶段使用。可以评估和识别药物靶点多态性对药物反应的影响。在临床研究中,可以根据患者的基因型(对应其代谢能力)使用药物遗传学测试对患者进行分层。这可以防止严重药物不良反应的发生,并有助于临床试验取得更好的结果。这也可以减少药物化合物的损耗。此外,随着更广泛地应用药物基因组学方法(如全基因组扫描、单倍型分析和候选基因方法),可以更好地研究药物反应的变化。随着新型高通量基因分型系统的出现,药物遗传学检测的成本已经变得非常低。然而,药物基因组学方法的成本仍然非常高。随着越来越多的药物治疗(如华法林和伊立替康)越来越受到药物遗传学的指导,FDA 已为制药公司制定了关于在标签中提交药物遗传学数据的指南。