Antiplatelet therapy guided by CYP2C19 point-of-care pharmacogenetics plus multidimensional treatment decisions.

IF 1.9 4区医学 Q3 PHARMACOLOGY & PHARMACY

Pharmacogenomics Pub Date : 2024-01-01 Epub Date: 2024-01-17 DOI:10.2217/pgs-2023-0200

Victor Voicu, Nicolas Diehm, Igal Moarof, Sarah Parejo, Florent Badiqué, Andrea Burden, David Niedrig, Markus Béchir, Stefan Russmann

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引用次数: 0

Abstract

Aim: Implementation of CYP2C19 point-of-care (POC) pharmacogenetic (PGx) testing with personalized treatment recommendations. Methods: POC CYP2C19 genotyping plus expert evaluation of risk factors for ischemic and bleeding events. Results: 167 patients underwent PGx testing, 54 (32.3%) were CYP2C19 loss of function carriers, and POC versus standard PGx analysis results for *2 and *3 variants matched in 100%. Antiplatelet therapy was adjusted in 44 patients (26.3%), but always required consideration of patient-specific factors. Conclusion: CYP2C19 POC-PGx is reliable and offers clinically relevant advantages for immediate evidence-based adaptations of antiplatelet therapy, whereas in less acute cases conventional PGx testing can also have advantages. Antiplatelet therapy has become more complex, and implementation of PGx-based personalized antiplatelet therapy requires complementary expert knowledge.

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以 CYP2C19 床旁药物遗传学为指导的抗血小板疗法加上多维治疗决策。

目的：实施具有个性化治疗建议的 CYP2C19 床旁（POC）药物基因（PGx）检测。方法：POC CYP2C19 基因分型POC CYP2C19 基因分型加上缺血和出血事件风险因素的专家评估。结果：167 名患者接受了 PGx 检测：167名患者接受了PGx检测，54人（32.3%）为CYP2C19功能缺失携带者，POC与标准PGx分析结果中*2和*3变体的匹配率为100%。44名患者（26.3%）的抗血小板疗法得到调整，但始终需要考虑患者的特异性因素。结论CYP2C19 POC-PGx 是可靠的，在临床上具有相关优势，可立即根据证据调整抗血小板疗法，而在急性病例较少的情况下，传统的 PGx 检测也具有优势。抗血小板疗法已变得更加复杂，实施基于 PGx 的个性化抗血小板疗法需要补充专家知识。

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来源期刊

Pharmacogenomics 医学-药学

CiteScore

3.40

自引率

9.50%

发文量

审稿时长

4-8 weeks

期刊介绍： Pharmacogenomics (ISSN 1462-2416) is a peer-reviewed journal presenting reviews and reports by the researchers and decision-makers closely involved in this rapidly developing area. Key objectives are to provide the community with an essential resource for keeping abreast of the latest developments in all areas of this exciting field. Pharmacogenomics is the leading source of commentary and analysis, bringing you the highest quality expert analyses from corporate and academic opinion leaders in the field.