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The long way to clinically actionable pharmacogenomic biomarkers

24. september 2017 at 13:31 | Veronika Valdova, ARETE-ZOE |  Medicine & Pharmacy
The impact of cytochromes P450 (CYP450) variability on drug metabolism and drug interactions is well known and long recognized in the community of medical and pharmaceutical professionals as a major contributor to avoidable patient casualty (1). Many active pharmaceutical ingredients are known substrates, inducers and inhibitors of CYP450 enzymes. Some CYP450s are highly polymorphic, namely CYP2C9, CYP2C19 and CYP2D6 (1). Anticoagulants, opioid analgesics, and antidiabetics are among drug classes that cause the highest number of adverse events (2, 3).

Well-documented concern, limited clinical use

Information about pharmacogenomic biomarkers listed in U.S. drug labels includes drug interactions with germline or somatic gene variants (polymorphisms, mutations), functional deficiencies with a genetic etiology, gene expression differences, chromosomal abnormalities and selected proteins used for treatment selection (4). Some healthcare facilities already offer PGX testing to their patients, e.g. CYP2C9 and VKORC1 to better predict response to warfarin and adjust dosing (5).



 

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