参与个性化医疗项目患者中可避免的药物-基因冲突及多重用药相互作用
Avoidable drug-gene conflicts and polypharmacy interactions in patients participating in a personalized medicine program.
作者信息
Reynolds Kristen K, Pierce Deanne L, Weitendorf Frederick, Linder Mark W
机构信息
PGXL Laboratories, Louisville, KY 40202, USA.
University of Louisville School of Medicine, Department of Pathology & Laboratory Medicine, Louisville, KY USA 40292.
出版信息
Per Med. 2017 May;14(3):221-233. doi: 10.2217/pme-2016-0095. Epub 2017 Mar 23.
AIM
Determine the ability of a pharmacogenetic service, PRIMER, to identify drug-gene (DGI) and drug-drug interactions (DDI) in patients across multiple conditions. PRIMER consists of patient selection criteria, a gene panel and actionable guidance for DGIs and DDIs.
RESULTS
The average patient was prescribed 12 medications. PRIMER identified significant DGIs in 73% of patients tested, with 43% having more than one DGI. DDIs were found in 87% of patients. The most common actionable DGIs were for opioid, psychotropic and cardiovascular medications.
CONCLUSION
The pairing of patient selection criteria, a multigene panel with evidence-based interpretation and review of DDIs maximizes the patients tested who have actionable benefit and alerts physicians to potentially critical adjustments needed for the patient's medication regimen.
目的
确定药物遗传学服务PRIMER在多种疾病患者中识别药物-基因（DGI）和药物-药物相互作用（DDI）的能力。PRIMER包括患者选择标准、基因检测组合以及针对DGI和DDI的可行指导。
结果
平均每位患者开具了12种药物。PRIMER在73%的检测患者中识别出显著的DGI，其中43%的患者有不止一种DGI。87%的患者发现了DDI。最常见的可采取行动的DGI涉及阿片类药物、精神药物和心血管药物。
结论
患者选择标准、具有循证解释的多基因检测组合以及对DDI的审查相结合，最大限度地增加了能从检测中获得可行益处的患者数量，并提醒医生注意患者药物治疗方案可能需要的关键调整。
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