Comparing the clinical utility of pharmacogenomic genotyping and next generation sequencing in a military health system adult medicine clinic.

IF 1.9 4区医学 Q3 PHARMACOLOGY & PHARMACY

Pharmacogenomics Pub Date : 2024-01-01 Epub Date: 2025-02-21 DOI:10.1080/14622416.2025.2466413

David Saunders, Lydia D Hellwig, Austin Pagani, Mauricio De Castro, Mark Haigney, Lucas Poon, Nate Ehat, Andrew Heroy, Joya Libbus, Keiko Fox, Sachi Kalra, Thomas B Arnold, Clesson Turner, John Logan Black, Steven E Scherer, Ann M Moyer

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引用次数: 0

Abstract

Introduction: Pharmacogenetic (PGx) screening is intended to optimize drug efficacy and reduce adverse drug reactions. Current screening options include genotyping assays for preselected PGx variants and broader next-generation sequencing panels (NGS). Few studies have directly compared preemptive PGx screening methods.

Materials and methods: The two PGx methods were compared in a cross-sectional study of adult Military Health System (MHS) clinic beneficiaries. Participants had initial targeted CYP2C19/CYP2D6 genotyping at a Military Health System Laboratory. Genotyping was followed by multi-gene NGS testing. Current prescriptions were recorded and potential drug-drug interactions screened to evaluate prescribing risk.

Results: All participants (100%) had at least one clinically actionable NGS panel result compared to 81% with targeted CYP2C19/CYP2D6 genotyping. Participants (n = 162) had an average of 6.6 (range 0-22) prescriptions and 2.7 (range 0-24) drug-drug interactions. Among those with at least one clinically actionable NGS result, 42% were currently taking medication with actionable CPIC guidelines (Level A/B), compared with 24% with CYP2C19/CYP2D6 genotyping. Sixteen participants (10%) had uncertain NGS panel results, with none for CYP2C19/CYP2D6 genotyping.

Conclusions: Preemptive multi-gene NGS detected more clinically actionable PGx results than targeted CYP2C19/CYP2D6 genotyping. Effective PGx screening in the MHS may decrease preventable adverse effects and improve military readiness.

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比较药物基因组基因分型和新一代测序在军事卫生系统成人医学诊所中的临床应用。

药物遗传学（PGx）筛选旨在优化药物疗效，减少药物不良反应。目前的筛选方案包括预先选择的PGx变体的基因分型分析和更广泛的下一代测序面板（NGS）。很少有研究直接比较先发制人的PGx筛查方法。材料与方法：比较两种PGx方法在军队卫生系统（MHS）成年门诊受益人的横断面研究中的差异。参与者在军事卫生系统实验室进行了最初的靶向CYP2C19/CYP2D6基因分型。基因分型后进行多基因NGS检测。记录当前处方并筛选潜在的药物-药物相互作用以评估处方风险。结果：所有参与者（100%）至少有一个临床可操作的NGS面板结果，而靶向CYP2C19/CYP2D6基因分型的比例为81%。参与者（n = 162）平均有6.6（范围0-22）处方和2.7（范围0-24）药物-药物相互作用。在至少有一个临床可操作的NGS结果的患者中，42%目前正在服用可操作的CPIC指南（A/B级）的药物，而CYP2C19/CYP2D6基因分型的患者为24%。16名参与者（10%）有不确定的NGS面板结果，没有CYP2C19/CYP2D6基因分型。结论：先发制人的多基因NGS比靶向CYP2C19/CYP2D6基因分型检测到更多临床可操作的PGx结果。在MHS中进行有效的PGx筛查可以减少可预防的不良反应并改善军事准备。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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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.