多基因药物遗传学检测对优化心血管疾病患者用药处方的预期影响。
Projected impact of a multigene pharmacogenetic test to optimize medication prescribing in cardiovascular patients.
作者信息
Dong Olivia M, Li Amy, Suzuki Oscar, Oni-Orisan Akinyemi, Gonzalez Ricardo, Stouffer George A, Lee Craig R, Wiltshire Tim
机构信息
Division of Pharmacotherapy & Experimental Therapeutics, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
Center for Pharmacogenomics & Individualized Therapy, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
出版信息
Pharmacogenomics. 2018 Jun 1;19(9):771-782. doi: 10.2217/pgs-2018-0049. Epub 2018 May 25.
AIM
To determine the projected impact of a multigene pharmacogenetic (PGx) test on medication prescribing.
MATERIALS & METHODS: A retrospective analysis was conducted with 122 cardiac catheterization laboratory patients undergoing angiography for eligibility of potential PGx-guided interventions that could have occurred if multigene PGx information was pre-emptively available at the time of the procedure. Medication data and presence of actionable at-risk genotypes were used to determine eligibility of a PGx intervention.
RESULTS
20% of the study population (n = 24) would have qualified for at least one PGx-based medication intervention per US FDA or Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines within 6 months of their cardiac catheterization procedure. Commonly encountered gene-drug pairs for these interventions included: CYP2C19 for clopidogrel and antidepressants, CYP2D6 for antidepressants and codeine, SLCO1B1 for simvastatin, and VKORC1/CYP2C9 for warfarin.
CONCLUSION
Pre-emptive use of a multigene PGx test in the cardiac catheterization laboratory offers potential to reduce adverse medication outcomes.
目的
确定多基因药物遗传学（PGx）检测对药物处方的预期影响。
材料与方法
对122例接受血管造影的心脏导管实验室患者进行回顾性分析，以确定如果在手术时预先获得多基因PGx信息，可能发生的潜在PGx指导干预的适用性。用药数据和可操作的风险基因型的存在用于确定PGx干预的适用性。
结果
根据美国食品药品监督管理局（FDA）或临床药物遗传学实施联盟（CPIC）的指南，20%的研究人群（n = 24）在心脏导管插入术后6个月内至少有一项基于PGx的药物干预符合条件。这些干预中常见的基因-药物对包括：用于氯吡格雷和抗抑郁药的CYP2C19、用于抗抑郁药和可待因的CYP2D6、用于辛伐他汀的SLCO1B1以及用于华法林的VKORC1/CYP2C9。
结论
在心脏导管实验室中预先使用多基因PGx检测有可能减少药物不良后果。
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