Pharmacogenetic Testing: A Tool for Personalized Drug Therapy Optimization

Abstract

Pharmacogenomics is a study of how the genome background is associated with drug resistance and how therapy strategy can be modified for a certain person to achieve benefit. The pharmacogenomics (PGx) testing becomes of great opportunity for physicians to make the proper decision regarding each non-trivial patient that does not respond to therapy. Although pharmacogenomics has become of growing interest to the healthcare market during the past five to ten years the exact mechanisms linking the genetic polymorphisms and observable responses to drug therapy are not always clear. Therefore, the success of PGx testing depends on the physician’s ability to understand the obtained results in a standardized way for each particular patient. The review aims to lead the reader through the general conception of PGx and related issues of PGx testing efficiency, personal data security, and health safety at a current clinical level.

Effects of Pharmacokinetic Gene Variation on Therapeutic Drug Levels and Antidepressant Treatment Response

“…Pharmacogenetics is the study of the response to drug therapy depending on a patientʼs genetic background 1 . In the context of precision medicine, pharmacogenetic (PGx) testing has gained significance as, in general, it can improve the effectiveness of drug prescriptions and minimize adverse effects 1 2 by considering a patientʼs genetic profile for drug selection or dose adjustment 3 4 5 . It is, therefore, increasingly suggested to include PGx in the selection of psychiatric medications 6 7 8 .…”

“…Applying PGx in clinical routine has begun only recently as there are several limitations that complicate the understanding of how and when using PGx in a clinical setting 6 7 14 . Limitations include the lack of a clear relationship between serum concentration and efficacy for some drugs, polypharmacy, high prevalence of comorbidities, overlapping phenotypes, the lack of guidelines on how to use pharmacogenetic information and the polygenic architecture of the response on antidepressants 1 3 6 7 14 15 . The Clinical Pharmacogenetics Implementation Consortium (CPIC) and the Dutch Pharmacogenetics Working Group have published peer-reviewed, evidence-based pharmacogenetic guidelines for CYP2D6 and CYP2C19 genotypes and dosing, in particular for tricyclic antidepressants and selective serotonin reuptake inhibitors 16 17 18 19 .…”

Pharmacogenomics: History, Development and Challenges

“…Pharmacogenomic testing has been incorporated into clinical practice but at a slower pace compared to the evolving advancements in genetic research [76,[87][88][89][90][91][92]. Many organizations and companies are trying to integrate and execute the pharmacogenomic testing of patients to provide them personalized therapy [93]. Some organizations have succeeded in implementing pharmacogenomics and are paving way for others.…”

Demand for Pharmacogenomics and Personalized Medicine in the United Arab Emirates

“…Some patients may not respond to drug therapy or suffer from toxic effects more than others [2,3]. Pharmacogenomic testing aims to personalize pharmacotherapy and reduce toxic effects caused by abnormal drug ADME or gene mutations that directly affect drug responses [4]. Recognizing the importance of genomic medicine and pharmacogenomic testing in PM, the government of the United Arab Emirates (UAE) recently began to support genomic projects, including the Emirati Genome Program genomics and pharmacogenomics research, and the Department of Genetics and Genomics of the College of Medicine and Health Sciences at the University of Emirates began to provide graduate certificates and perform research in pharmacogenomics.…”