Evaluating the extent of reusability of CYP2C19 genotype data among patients genotyped for antiplatelet therapy selection.

Genetics in Medicine : Official Journal of the American College of Medical Genetics
Amber L BeitelsheesIGNITE Pharmacogenetics WorkingGroup

Abstract

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 for CYP2C19 to guide antiplatelet therapy were prescribed additional medications affected by CYP2C19. We assembled a cohort of patients from eight sites performingCYP2C19 genotyping 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. 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. More than half of patients genotyped in the setting of CYP2C19-guided antiplatelet therapy received another medication impacted by CYP2C19 in the following year. Given that genotype is stable for a pati...Continue Reading

References

Feb 3, 2011·JAMA : the Journal of the American Medical Association·Ruben L J OsnabruggeA Cecile J W Janssens
May 24, 2013·Clinical Pharmacology and Therapeutics·S A ScottUNKNOWN Clinical Pharmacogenetics Implementation Consortium
May 15, 2015·Clinical Pharmacology and Therapeutics·J K HicksUNKNOWN Clinical Pharmacogenetics Implementation Consortium
Sep 23, 2016·Genetics in Medicine : Official Journal of the American College of Medical Genetics·Deanna Alexis CarereRobert C Green
Dec 17, 2016·Clinical Pharmacology and Therapeutics·B MoriyamaT J Walsh
Dec 28, 2017·Clinical Pharmacology and Therapeutics·Philip E EmpeyUNKNOWN IGNITE Network
Sep 4, 2019·The New England Journal of Medicine·Daniel M F ClaassensJurriën M Ten Berg
Sep 15, 2019·Clinical Pharmacology and Therapeutics·Cyrine E HaidarJames M Hoffman
Feb 12, 2020·The Pharmacogenomics Journal·Nita A LimdiUNKNOWN Implementing GeNomics In pracTicE (IGNITE) Network Pharmacogenetic Working Group (IGNITE-PGx)

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Citations

Jul 21, 2021·Genetics in Medicine : Official Journal of the American College of Medical Genetics·Julio D DuarteUNKNOWN IGNITE Network Pharmacogenetics Working Group

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Methods Mentioned

BETA
genotyping

Software Mentioned

GeNomics PracTice

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