Yoon Deok Yong, Lee Soyoung, Ban Mu Seong, Jang In-Jin, Lee SeungHwan
Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul 03080, Korea.
Transl Clin Pharmacol. 2020 Dec;28(4):189-198. doi: 10.12793/tcp.2020.28.e18. Epub 2020 Dec 11.
There are several hurdles to overcome before implementing pharmacogenomics (PGx) in precision medicine. One of the hurdles is unawareness of PGx by clinicians due to insufficient pharmacogenomic information on drug labels. Therefore, it might be important to implement PGx that reflects pharmacogenomic information on drug labels, standard of prescription for clinicians. This study aimed to evaluate the level at which PGx was being used in clinical practice by comparing the Clinical Pharmacogenetics Implementation Consortium and Dutch Pharmacogenetics Working Group guidelines and drug labels of the US Food and Drug Administration (FDA) and the Korea Ministry of Food and Drug Safety (MFDS). Two PGx guidelines and drugs labels were scrutinized, and the concordance of the pharmacogenomic information between guidelines and drug labels was confirmed. The concordance of the label between FDA and MFDS was analyzed. In FDA labels, the number of concordant drug with guidelines was 24, while 13 drugs were concordant with MFDS labels. The number of drugs categorized as contraindication, change dose, and biomarker testing required was 7, 12 and 12 for the FDA and 8, 5 and 4 for the MFDS, respectively. The pharmacogenomic information of 9 drugs approved by both FDA and MFDS was identical. In conclusion, pharmacogenomic information on clinical implementation guidelines was limited on both FDA and MFDS labels because of various reasons including the characteristics of the guidelines and the drug labels. Therefore, more effort from pharmaceutical companies, academia and regulatory affairs needs to be made to implement pharmacogenomic information on drug labels.
在精准医学中实施药物基因组学(PGx)之前,有几个障碍需要克服。其中一个障碍是临床医生对PGx缺乏了解,因为药品标签上的药物基因组学信息不足。因此,实施反映药品标签上药物基因组学信息的PGx可能很重要,这是临床医生的处方标准。本研究旨在通过比较临床药物基因组学实施联盟和荷兰药物基因组学工作组的指南以及美国食品药品监督管理局(FDA)和韩国食品药品安全部(MFDS)的药品标签,评估PGx在临床实践中的使用水平。对两项PGx指南和药品标签进行了审查,并确认了指南与药品标签之间药物基因组学信息的一致性。分析了FDA和MFDS标签之间的一致性。在FDA标签中,与指南一致的药物有24种,而与MFDS标签一致的药物有13种。FDA分类为禁忌、改变剂量和需要进行生物标志物检测的药物数量分别为7种、12种和12种,MFDS分别为8种、5种和4种。FDA和MFDS都批准的9种药物的药物基因组学信息相同。总之,由于包括指南和药品标签的特点在内的各种原因,FDA和MFDS标签上关于临床实施指南的药物基因组学信息都很有限。因此,制药公司、学术界和监管事务需要做出更多努力,以在药品标签上实施药物基因组学信息。