The Case for Pre-Emptive Pharmacogenetic Screening in South Africa

被引:3
作者
Hurrell, Tracey [1 ]
Naidoo, Jerolen [1 ]
Masimirembwa, Collen [2 ,3 ]
Scholefield, Janine [1 ,4 ,5 ]
机构
[1] CSIR, Bioengn & Integrated Genom Grp, Future Prod Chem Cluster, ZA-0001 Pretoria, South Africa
[2] African Inst Biomed Sci & Technol, Harare 00263, Zimbabwe
[3] Univ Witwatersrand, Sydney Brenner Inst Mol Biol, Fac Hlth Sci, Div Human Genet, ZA-2193 Johannesburg, South Africa
[4] Univ Cape Town, Fac Hlth Sci, Dept Human Biol, ZA-7925 Cape Town, South Africa
[5] Univ Witwatersrand, Fac Hlth Sci, Div Human Genet, ZA-2193 Johannesburg, South Africa
来源
JOURNAL OF PERSONALIZED MEDICINE | 2024年 / 14卷 / 01期
基金
比尔及梅琳达.盖茨基金会;
关键词
Africa; pharmacogenetics; adverse drug reactions; pre-emptive screening; IMPLEMENTATION CONSORTIUM; GUIDELINES; RESOURCES; KNOWLEDGE; DIVERSITY; BENEFITS; PREPARE; GENOMES; SAFETY; CARE;
D O I
10.3390/jpm14010114
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Lack of equitable representation of global genetic diversity has hampered the implementation of genomic medicine in under-represented populations, including those on the African continent. Data from the multi-national Pre-emptive Pharmacogenomic Testing for Preventing Adverse Drug Reactions (PREPARE) study suggest that genotype guidance for prescriptions reduced the incidence of clinically relevant adverse drug reactions (ADRs) by 30%. In this study, hospital dispensary trends from a tertiary South African (SA) hospital (Steve Biko Academic Hospital; SBAH) were compared with the drugs monitored in the PREPARE study. Dispensary data on 29 drugs from the PREPARE study accounted for similar to 10% of total prescriptions and similar to 9% of the total expenditure at SBAH. VigiLyze data from the South African Health Products Regulatory Authority were interrogated for local ADRs related to these drugs; 27 were listed as being suspected, concomitant, or interacting in ADR reports. Furthermore, a comparison of pharmacogene allele frequencies between African and European populations was used to frame the potential impact of pre-emptive pharmacogenetic screening in SA. Enumerating the benefit of pre-emptive pharmacogenetic screening in SA will only be possible once we initiate its full application. However, regional genomic diversity, disease burden, and first-line treatment options could be harnessed to target stratified PGx today.
引用
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页数:14
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