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评估药物基因组检测以识别细胞色素P450和SLCO1B1酶及药物不良事件:一项非实验性观察性研究。

Evaluation of pharmacogenomic testing to identify cytochrome P450 and SLCO1B1 enzymes and adverse drug events: A non-experimental observational research.

作者信息

Flowers-Moore Tiffany, Rapp Alexandra R, Salazar Jose H, Rajendran Rajkumar

机构信息

Department of Clinical Laboratory Sciences, University of Texas Medical Branch, Galveston, TX.

Department of Pathology, University of Texas Medical Branch, Galveston, TX.

出版信息

Medicine (Baltimore). 2025 Apr 4;104(14):e42031. doi: 10.1097/MD.0000000000042031.

Abstract

A laboratory-initiated preemptive and reactive cytochrome P450 and SLCO1B1 PGx testing protocol was evaluated in a private toxicology laboratory with the intent of identifying enzyme frequencies and associated adverse drug events. This study involved non-experimental observational research. During the retrospective medical chart review, patient demographics, statements of medical necessity, and PGx testing data were collected. Frequencies and percentages were calculated for the collected data, and statistical analysis was performed using Intellectus online software. A total of 192 PGx patient records from September 2019 to October 2021 were retrospectively reviewed. For patient demographics, men (n = 118; (61%)) were the majority gender identified among the patient population and Caucasians (n = 112; (58%)) followed by African Americans (n = 37; (19%)) were the most identified ancestry. The mean age of the patients was 69 (±9) years. CYP1A2 hyperinducers, followed by CYP3A5 poor metabolizers and CYP2B6 intermediate metabolizers, are the most encountered cytochrome P450 and SLCO1B1 enzymes. Regarding drug-gene interactions, 41 patients had 1 interaction, 29 had 2, and 31 had 3 or more interactions. For drug-drug interactions, 35 patients had 1 interaction, 15 had 2, and 30 had 3 or more interactions. Overall, 123 patients showed a minor or greater impact on drug-drug or drug-gene interactions. Overall, our study identified cytochrome P450 and SCLCO1B1 enzyme frequencies and patients experiencing actionable adverse drug events. By raising awareness of PGx test results through individualized clinician training, education, and interventions, these adverse events can be promptly identified and resolved.

摘要

在一家私人毒理学实验室对一项由实验室发起的先发制和反应性细胞色素P450及SLCO1B1药物基因组学(PGx)检测方案进行了评估,目的是确定酶频率及相关药物不良事件。本研究涉及非实验性观察性研究。在回顾性病历审查期间,收集了患者人口统计学信息、医疗必要性声明及PGx检测数据。对收集的数据计算频率和百分比,并使用Intellectus在线软件进行统计分析。回顾性审查了2019年9月至2021年10月期间共192份PGx患者记录。就患者人口统计学而言,男性(n = 118;(61%))是患者群体中占多数的性别,白种人(n = 112;(58%))其次是非洲裔美国人(n = 37;(19%))是最常见的血统。患者的平均年龄为69(±9)岁。细胞色素P450和SLCO1B1酶中最常遇到的是CYP1A2超诱导剂,其次是CYP3A5慢代谢者和CYP2B6中间代谢者。关于药物-基因相互作用,41名患者有1种相互作用,29名有2种,31名有3种或更多相互作用。对于药物-药物相互作用,35名患者有1种相互作用,15名有2种,30名有3种或更多相互作用。总体而言,123名患者在药物-药物或药物-基因相互作用方面显示出轻微或更大的影响。总体而言,我们的研究确定了细胞色素P450和SCLCO1B1酶频率以及经历可采取行动的药物不良事件的患者。通过个性化的临床医生培训、教育和干预提高对PGx检测结果的认识,这些不良事件可以被及时识别和解决。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/965c/11977719/4c80a02d1b0c/medi-104-e42031-g001.jpg

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