Evaluating the extent of reusability ofCYP2C19genotype data among patients genotyped for antiplatelet therapy selection

被引：10

作者：

Beitelshees, Amber L. ^{[1
,2
]}

Stevenson, James M. ^{[3
]}

El Rouby, Nihal ^{[4
,5
,6
]}

Dillon, Chrisly ^{[7
,8
]}

Empey, Philip E. ^{[3
]}

Fielstein, Elliot M. ^{[9
]}

Johnson, Julie A. ^{[4
,5
]}

Limdi, Nita A. ^{[7
,8
]}

Ong, Henry H. ^{[10
]}

Franchi, Francesco ^{[11
]}

Angiolillo, Dominick P. ^{[11
]}

Peterson, Joshua F. ^{[9
]}

Rosenman, Marc B. ^{[12
,13
,14
]}

Skaar, Todd C. ^{[15
]}

Tuteja, Sony ^{[16
]}

Cavallari, Larisa H. ^{[4
,5
]}

机构：

[1] Univ Maryland, Sch Med, Dept Med, Baltimore, MD 21201 USA

[2] Univ Maryland, Sch Med, Program Personalized & Genom Med, Baltimore, MD 21201 USA

[3] Univ Pittsburgh, Sch Pharm, Dept Pharm & Therapeut, Pittsburgh, PA 15261 USA

[4] Univ Florida, Coll Pharm, Dept Pharmacotherapy & Translat Res, Gainesville, FL USA

[5] Univ Florida, Coll Pharm, Ctr Pharmacogen & Precis Med, Gainesville, FL USA

[6] Univ Cincinnati, James L Winkle Coll Pharm, Dept Pharm Practice & Adm Sci, Cincinnati, OH USA

[7] Univ Alabama Birmingham, Birmingham, AL USA

[8] Hugh Kaul Precis Med Inst, Birmingham, AL USA

[9] Vanderbilt Univ, Med Ctr, Dept Biomed Informat & Med, Nashville, TN USA

[10] Vanderbilt Univ, Med Ctr, Vanderbilt Inst Clin & Translat Res, Nashville, TN USA

[11] Univ Florida, Coll Med, Dept Med, Div Cardiol, Jacksonville, FL USA

[12] Indiana Univ Sch Med, Dept Pediat, Indianapolis, IN 46202 USA

[13] Ann & Robert H Lurie Childrens Hosp Chicago, Chicago, IL 60611 USA

[14] Northwestern Univ, Chicago, IL 60611 USA

[15] Indiana Univ Sch Med, Dept Med, Indianapolis, IN 46202 USA

[16] Univ Penn, Dept Med, Perelman Sch Med, Div Translat Med & Human Genet, Philadelphia, PA 19104 USA

来源：

GENETICS IN MEDICINE | 2020年 / 22卷 / 11期

基金：

美国国家卫生研究院;

关键词：

pharmacogenetics; CYP2C19; GENOTYPE; COST-EFFECTIVENESS; CLOPIDOGREL; IMPLEMENTATION; OUTCOMES; GUIDELINES;

D O I：

10.1038/s41436-020-0894-2

中图分类号：

Q3 [遗传学];

学科分类号：

071007 ; 090102 ;

摘要：

Purpose Genotype-guided antiplatelet therapy is increasingly being incorporated into clinical care. The purpose of this study is to determine the extent to which patients initially genotyped forCYP2C19to guide antiplatelet therapy were prescribed additional medications affected byCYP2C19. Methods We assembled a cohort of patients from eight sites performingCYP2C19genotyping to inform antiplatelet therapy. Medication orders were evaluated from time of genotyping through one year. The primary endpoint was the proportion of patients prescribed two or more CYP2C19 substrates. Secondary endpoints were the proportion of patients with a drug-genotype interaction and time to receiving a CYP2C19 substrate. Results Nine thousand one hundred ninety-one genotyped patients (17% nonwhite) with a mean age of 68 +/- 3 years were evaluated; 4701 (51%) of patients received two or more CYP2C19 substrates and 3835 (42%) of patients had a drug-genotype interaction. The average time between genotyping and CYP2C19 substrate other than antiplatelet therapy was 25 +/- 10 days. Conclusions More than half of patients genotyped in the setting ofCYP2C19-guided antiplatelet therapy received another medication impacted by CYP2C19 in the following year. Given that genotype is stable for a patient's lifetime, this finding has implications for cost effectiveness, patient care, and treatment outcomes beyond the indication for which it was originally performed.

引用

页码：1898 / 1902

页数：5

共 18 条

[1] Prescription medication changes following direct-to-consumer personal genomic testing: findings from the Impact of Personal Genomics (PGen) Study [J].

Carere, Deanna Alexis ;

VanderWeele, Tyler J. ;

Vassy, Jason L. ;

van der Wouden, Cathelijne H. ;

Roberts, J. Scott ;

Kraft, Peter ;

Green, Robert C. .

GENETICS IN MEDICINE, 2017, 19 (05) :537-545

[2] Multisite Investigation of Outcomes With Implementation of CYP2C19 Genotype-Guided Antiplatelet Therapy After Percutaneous Coronary Intervention [J].

Cavallari, Larisa H. ;

Lee, Craig R. ;

Beitelshees, Amber L. ;

Cooper-DeHoff, Rhonda M. ;

Duarte, Julio D. ;

Voora, Deepak ;

Kimmel, Stephen E. ;

McDonough, Caitrin W. ;

Gong, Yan ;

Dave, Chintan V. ;

Pratt, Victoria M. ;

Alestock, Tameka D. ;

Anderson, R. David ;

Alsip, Jorge ;

Ardati, Amer K. ;

Brott, Brigitta C. ;

Brown, Lawrence ;

Chumnumwat, Supatat ;

Clare-Salzler, Michael J. ;

Coons, James C. ;

Denny, Joshua C. ;

Dillon, Chrisly ;

Elsey, Amanda R. ;

Hamadeh, Issam S. ;

Harada, Shuko ;

Hillegass, William B. ;

Hines, Lindsay ;

Horenstein, Richard B. ;

Howell, Lucius A. ;

Jeng, Linda J. B. ;

Kelemen, Mark D. ;

Lee, Yee Ming ;

Magvanjav, Oyunbileg ;

Montasser, May ;

Nelson, David R. ;

Nutescu, Edith A. ;

Nwaba, Devon C. ;

Pakyz, Ruth E. ;

Palmer, Kathleen ;

Peterson, Josh F. ;

Pollin, Toni I. ;

Quinn, Alison H. ;

Robinson, Shawn W. ;

Schub, Jamie ;

Skaar, Todd C. ;

Smith, D. Max ;

Sriramoju, Vindhya B. ;

Starostik, Petr ;

Stys, Tomasz P. ;

Stevenson, James M. .

JACC-CARDIOVASCULAR INTERVENTIONS, 2018, 11 (02) :181-191

[3] A Genotype-Guided Strategy for Oral P2Y12 Inhibitors in Primary PCI [J].

Claassens, Daniel M. F. ;

Vos, Gerrit J. A. ;

Bergmeijer, Thomas O. ;

Hermanides, Renicus S. ;

van 't Hof, Arnoud W. J. ;

van der Harst, Pim ;

Barbato, Emanuele ;

Morisco, Carmine ;

Gin, Richard M. Tjon Joe ;

Asselbergs, Folkert W. ;

Mosterd, Arend ;

Herrman, Jean-Paul R. ;

Dewilde, Willem J. M. ;

Janssen, Paul W. A. ;

Kelder, Johannes C. ;

Postma, Maarten J. ;

de Boer, Anthonius ;

Boersma, Cornelis ;

Deneer, Vera H. M. ;

ten Berg, Jurrien M. .

NEW ENGLAND JOURNAL OF MEDICINE, 2019, 381 (17) :1621-1631

[4] Multisite Investigation of Strategies for the Implementation of CYP2C19 Genotype-Guided Antiplatelet Therapy [J].

Empey, Philip E. ;

Stevenson, James M. ;

Tuteja, Sony ;

Weitzel, Kristin W. ;

Angiolillo, Dominick J. ;

Beitelshees, Amber L. ;

Coons, James C. ;

Duarte, Julio D. ;

Franchi, Francesco ;

Jeng, Linda J. B. ;

Johnson, Julie A. ;

Kreutz, Rolf P. ;

Limdi, Nita A. ;

Maloney, Kristin A. ;

Obeng, Aniwaa Owusu ;

Peterson, Josh F. ;

Petry, Natasha ;

Pratt, Victoria M. ;

Rollini, Fabiana ;

Scott, Stuart A. ;

Skaar, Todd C. ;

Vesely, Mark R. ;

Stouffer, George A. ;

Wilke, Russell A. ;

Cavallari, Larisa H. ;

Lee, Craig R. .

CLINICAL PHARMACOLOGY & THERAPEUTICS, 2018, 104 (04) :664-674

[5]

GenomeWeb, 2019, NEW COAL STAK GROUPS

[6] Preemptively Precise: Returning and Updating Pharmacogenetic Test Results to Realize the Benefits of Preemptive Testing [J].

Haidar, Cyrine E. ;

Relling, Mary V. ;

Hoffman, James M. .

CLINICAL PHARMACOLOGY & THERAPEUTICS, 2019, 106 (05) :942-944

[7] Clinical Pharmacogenetics Implementation Consortium Guideline (CPIC) for CYP2D6 and CYP2C19 Genotypes and Dosing of Tricyclic Antidepressants: 2016 Update [J].

Hicks, J. K. ;

Sangkuhl, K. ;

Swen, J. J. ;

Ellingrod, V. L. ;

Muller, D. J. ;

Shimoda, K. ;

Bishop, J. R. ;

Kharasch, E. D. ;

Skaar, T. C. ;

Gaedigk, A. ;

Dunnenberger, H. M. ;

Klein, T. E. ;

Caudle, K. E. ;

Stingl, J. C. .

CLINICAL PHARMACOLOGY & THERAPEUTICS, 2017, 102 (01) :37-44

[8] Clinical Pharmacogenetics Implementation Consortium (CPIC) Guideline for CYP2D6 and CYP2C19 Genotypes and Dosing of Selective Serotonin Reuptake Inhibitors [J].

Hicks, J. K. ;

Bishop, J. R. ;

Sangkuhl, K. ;

Mueller, D. J. ;

Ji, Y. ;

Leckband, S. G. ;

Leeder, J. S. ;

Graham, R. L. ;

Chiulli, D. L. ;

LLerena, A. ;

Skaar, T. C. ;

Scott, S. A. ;

Stingl, J. C. ;

Klein, T. E. ;

Caudle, K. E. ;

Gaedigk, A. .

CLINICAL PHARMACOLOGY & THERAPEUTICS, 2015, 98 (02) :127-134

[9] Cost-effectiveness of CYP2C19-guided antiplatelet therapy in patients with acute coronary syndrome and percutaneous coronary intervention informed by real-world data [J].

Limdi, Nita A. ;

Cavallari, Larisa H. ;

Lee, Craig R. ;

Hillegass, William B. ;

Holmes, Ann M. ;

Skaar, Todd C. ;

Pisu, Maria ;

Dillon, Chrisly ;

Beitelshees, Amber L. ;

Empey, Philip E. ;

Duarte, Julio D. ;

Diaby, Vakaramoko ;

Gong, Yan ;

Johnson, Julie A. ;

Graves, John ;

Garbett, Shawn ;

Zhou, Zilu ;

Peterson, Josh F. .

PHARMACOGENOMICS JOURNAL, 2020, 20 (05) :724-735

[10] Genetic variants in ABCB1 and CYP2C19 and cardiovascular outcomes after treatment with clopidogrel and prasugrel in the TRITON-TIMI 38 trial: a pharmacogenetic analysis [J].

Mega, Jessica L. ;

Close, Sandra L. ;

Wiviott, Stephen D. ;

Shen, Lei ;

Walker, Joseph R. ;

Simon, Tabassome ;

Antman, Elliott M. ;

Braunwald, Eugene ;

Sabatine, Marc S. .

LANCET, 2010, 376 (9749) :1312-1319

← 1 2 →