预测药物基因组检测对经皮冠状动脉介入治疗患者抗血小板治疗以外药物的影响。
Projected impact of pharmacogenomic testing on medications beyond antiplatelet therapy in percutaneous coronary intervention patients.
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.
Department of Pathology & Laboratory Medicine, UNC School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.
出版信息
Pharmacogenomics. 2020 May;21(7):431-441. doi: 10.2217/pgs-2019-0185. Epub 2020 Apr 28.
Abstract
genotyping is used to guide antiplatelet therapy after percutaneous coronary intervention (PCI). This study evaluated the potential impact of and multigene pharmacogenomics (PGx) testing on medications beyond antiplatelet therapy in a real-world cohort of PCI patients that underwent testing. Multiple medications with actionable PGx recommendations, including proton pump inhibitors, antidepressants and opioids, were commonly prescribed. Approximately 50% received a CYP2C19 metabolized medication beyond clopidogrel and 7% met criteria for a genotype-guided intervention. A simulation analysis projected that 17.5 PGx-guided medication interventions per 100 PCI patients could have been made if multigene PGx results were available. This suggests that and multigene PGx results could be used to optimize medication prescribing beyond antiplatelet therapy in PCI patients.
摘要
基因分型用于指导经皮冠状动脉介入治疗（PCI）后的抗血小板治疗。本研究评估了在接受基因分型检测的 PCI 患者的真实队列中，多基因药物基因组学（PGx）检测对除抗血小板治疗以外的药物的潜在影响。许多具有可操作的 PGx 推荐的药物，包括质子泵抑制剂、抗抑郁药和阿片类药物，都被广泛使用。大约 50%的患者接受了除氯吡格雷以外的 CYP2C19 代谢药物，7%的患者符合基因型指导干预的标准。一项模拟分析预测，如果有多种基因 PGx 结果，每 100 例 PCI 患者可能会进行 17.5 次 PGx 指导的药物干预。这表明，和多基因 PGx 结果可用于优化 PCI 患者除抗血小板治疗以外的药物处方。
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Value Health. 2020 Jan;23(1):61-73. doi: 10.1016/j.jval.2019.08.002. Epub 2019 Sep 25.
2
Projected Cost-Effectiveness for 2 Gene-Drug Pairs Using a Multigene Panel for Patients Undergoing Percutaneous Coronary Intervention.多基因panel 用于行经皮冠状动脉介入治疗患者的 2 个基因药物对的预计成本效益。
Value Health. 2019 Nov;22(11):1231-1239. doi: 10.1016/j.jval.2019.05.015. Epub 2019 Oct 16.
3
A Genotype-Guided Strategy for Oral P2Y Inhibitors in Primary PCI.一种基于基因型的急性 ST 段抬高型心肌梗死直接经皮冠状动脉介入治疗中口服 P2Y12 抑制剂的策略。
N Engl J Med. 2019 Oct 24;381(17):1621-1631. doi: 10.1056/NEJMoa1907096. Epub 2019 Sep 3.
4
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5
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J Am Coll Cardiol. 2019 Apr 16;73(14):1827-1845. doi: 10.1016/j.jacc.2019.01.041.
6
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7
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JAMA Intern Med. 2018 Jul 1;178(7):943-950. doi: 10.1001/jamainternmed.2018.0783.
8
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Pharmacogenomics. 2018 Jun 1;19(9):771-782. doi: 10.2217/pgs-2018-0049. Epub 2018 May 25.
9
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Expert Opin Drug Metab Toxicol. 2018 Apr;14(4):447-460. doi: 10.1080/17425255.2018.1461835. Epub 2018 Apr 12.
10
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