Use of pharmacogenomics in elderly patients treated for cardiovascular diseases

Božina, Nada; Kirhmajer, Majda Vrkić; Šimičević, Livija; Ganoci, Lana; Skvrce, Nikica Mirošević; Domjanović, Iva Klarica; Merćep, Iveta

doi:10.3325/cmj.2020.61.147

Cited by 5 publications

(4 citation statements)

References 79 publications

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“…Table 2 shows the PGx of lipid-modifying agents; and Table 3 shows the PGx of antithrombotic drugs, including vitamin K antagonists, heparins, platelet aggregation inhibitors, direct thrombin inhibitors, and direct factor Xa inhibitors. Most of these drugs are taken in a polypharmacy fashion (>6 drugs/day), with the consequent increase in DDIs and ADRs [101]. In patients with these health conditions, PGx pre-emptive testing is highly recommended to improve efficacy and minimize toxicity [102]; however, the PGx of cardiovascular and related disorders in practice is still in a very primitive stage, despite the abundance of information available for the personalized use of cardiovascular drugs [23,103] (Tables 1-3).…”

Section: Ethnic Differences In Adrsmentioning

confidence: 99%

Genophenotypic Factors and Pharmacogenomics in Adverse Drug Reactions

Cacabelos

Naidoo

Corzo

et al. 2021

IJMS

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Adverse drug reactions (ADRs) rank as one of the top 10 leading causes of death and illness in developed countries. ADRs show differential features depending upon genotype, age, sex, race, pathology, drug category, route of administration, and drug–drug interactions. Pharmacogenomics (PGx) provides the physician effective clues for optimizing drug efficacy and safety in major problems of health such as cardiovascular disease and associated disorders, cancer and brain disorders. Important aspects to be considered are also the impact of immunopharmacogenomics in cutaneous ADRs as well as the influence of genomic factors associated with COVID-19 and vaccination strategies. Major limitations for the routine use of PGx procedures for ADRs prevention are the lack of education and training in physicians and pharmacists, poor characterization of drug-related PGx, unspecific biomarkers of drug efficacy and toxicity, cost-effectiveness, administrative problems in health organizations, and insufficient regulation for the generalized use of PGx in the clinical setting. The implementation of PGx requires: (i) education of physicians and all other parties involved in the use and benefits of PGx; (ii) prospective studies to demonstrate the benefits of PGx genotyping; (iii) standardization of PGx procedures and development of clinical guidelines; (iv) NGS and microarrays to cover genes with high PGx potential; and (v) new regulations for PGx-related drug development and PGx drug labelling.

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Section: Ethnic Differences In Adrsmentioning

confidence: 99%

Genophenotypic Factors and Pharmacogenomics in Adverse Drug Reactions

Cacabelos

Naidoo

Corzo

et al. 2021

IJMS

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“…In the guidelines provided by the PGx consortium, one can find instructions on the correct administration of oral antiplatelet medicines, anticoagulants, beta-blockers, and statins. The need to produce tools for predicting multiple drug-drug-gene interactions is necessary as it's prevalent in elderly comorbid patients, and currently, most only assess single drug-gene interactions [55]. Combinatorial PGx testing has proved to help select medications for older patients suffering from depression compared to the treatment-as-usual (TAU) approach [56].…”

Section: Pgx and Geriatric Patient Carementioning

confidence: 99%

Translational Pharmacogenomics Augmenting Pharmacotherapy

Uppaluri¹

2023

J Clin Genet Hered.

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Pharmacogenomics (PGx), the intertwined knowledge of pharmacology and genomics, is well known. Taking PGx in pace with modern sequencing technological advancements is essential for effective clinical utilization, implementation, and personalized treatment care. Molecular profiling is a technique used to analyze the genetic and molecular makeup of an individual's cancer or other diseases. Decisions on a patient's course of treatment, including the choice of an appropriate pharmacotherapy, can be made using this information. For example, molecular analysis can pinpoint genetic changes that increase a patient's propensity to respond to a particular treatment. It can also reveal potential resistance mechanisms, which helps choose effective treatments for patients. In addition, molecular profiling can help to identify possible side effects that a patient may experience when taking certain medications. Overall, molecular profiling can be a valuable tool in helping to optimize pharmacotherapy for an individual patient. This review highlights the history of PGx, the role of pharmacogenes, PGx guidelines, the interrelation between PGx and personalized medicine, PGx technologies, challenges, and solutions in the implementation of PGx, international and national execution of PGx, and PGx in geriatric patient care, pediatric patient care, maternal, fetal medicine, general medicine, and oncology with a focus on the international and national scenarios. This review aims to better elucidate PGx for clinical implementation by healthcare workers, clinicians, and researchers to ensure efficient, safe, and cost-effective pharmacotherapeutic treatment plans for patients.

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“…Similarly, knowledge gaps still exist with regards to PGx and drug-gene associations in the elderly populations. Morbidity, mortality, and health care costs due to adverse drug reactions (ADRs) in the elderly is a major public health concern although many of which are predictable and avoidable ( Onder et al, 2013 ; Bozina et al, 2020 ; Roman et al, 2020 ; Hoel et al, 2021 ). With a growing aging population, the economic burden of management and hospitalizations due to ADRs will only be exacerbated ( Maher et al, 2014 ; Formica et al, 2018 ; Perez-Jover et al, 2018 ; Malki and Pearson, 2020 ).…”

Section: Introductionmentioning

confidence: 99%

“…With a growing aging population, the economic burden of management and hospitalizations due to ADRs will only be exacerbated ( Maher et al, 2014 ; Formica et al, 2018 ; Perez-Jover et al, 2018 ; Malki and Pearson, 2020 ). Evidence is growing to support the utility of PGx in guiding treatment regimens in older patients ( Bozina et al, 2020 ; Inventor and Paun, 2021 ). Significantly higher rates of hospitalizations are observed in patients with polypharmacy (5 or more drugs) who harbor large number of PGx polymorphisms compared to those with polypharmacy and no or less genetic variants, while the rates of hospitalizations decrease and cost savings per patient increase if PGx-guided treatment is followed ( Finkelstein et al, 2016a ; Finkelstein et al, 2016b ; Brixner et al, 2016 ).…”

Section: Introductionmentioning

confidence: 99%

Pharmacogenomics and health disparities, are we helping?

Shaaban

Yuan

2023

Front. Genet.

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Pharmacogenomics has been at the forefront of precision medicine during the last few decades. Precision medicine carries the potential of improving health outcomes at both the individual as well as population levels. To harness the benefits of its initiatives, careful dissection of existing health disparities as they relate to precision medicine is of paramount importance. Attempting to address the existing disparities at the early stages of design and implementation of these efforts is the only guarantee of a successful just outcome. In this review, we glance at a few determinants of existing health disparities as they intersect with pharmacogenomics research and implementation. In our opinion, highlighting these disparities is imperative for the purpose of researching meaningful solutions. Failing to identify, and hence address, these disparities in the context of the current and future precision medicine initiatives would leave an already strained health system, even more inundated with inequality.

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Use of pharmacogenomics in elderly patients treated for cardiovascular diseases

Cited by 5 publications

References 79 publications

Genophenotypic Factors and Pharmacogenomics in Adverse Drug Reactions

Genophenotypic Factors and Pharmacogenomics in Adverse Drug Reactions

Translational Pharmacogenomics Augmenting Pharmacotherapy

Pharmacogenomics and health disparities, are we helping?

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