Cargando…
Retrospective Review of Pharmacogenetic Testing at an Academic Children’s Hospital
There is limited evidence to support pharmacogenetic (PGx) testing in children. We conducted a retrospective review of PGx testing among 452 patients at an academic children’s hospital to determine the potential utility of PGx in diseases of childhood and to identify targets for future pediatric pha...
Autores principales: | , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7877836/ https://www.ncbi.nlm.nih.gov/pubmed/33048453 http://dx.doi.org/10.1111/cts.12895 |
_version_ | 1783650247779549184 |
---|---|
author | Roberts, Timothy A. Wagner, Jennifer A. Sandritter, Tracy Black, Benjamin T. Gaedigk, Andrea Stancil, Stephani L. |
author_facet | Roberts, Timothy A. Wagner, Jennifer A. Sandritter, Tracy Black, Benjamin T. Gaedigk, Andrea Stancil, Stephani L. |
author_sort | Roberts, Timothy A. |
collection | PubMed |
description | There is limited evidence to support pharmacogenetic (PGx) testing in children. We conducted a retrospective review of PGx testing among 452 patients at an academic children’s hospital to determine the potential utility of PGx in diseases of childhood and to identify targets for future pediatric pharmacogenetic research. An actionable gene‐drug pair associated with the 28 genes tested (Clinical Pharmacogenetics Implementation Consortium (CPIC) level A or B, Pharmacogenomics Knowledge Base (PharmGKB) level 1A or B, or US Food and Drug Administration (FDA) recommendation and a PharmGKB level) was present in 98.7% of patients. We identified 203 actionable gene‐drug‐diagnosis groups based on the indications for each actionable drug listed in Lexicomp. Among patients with an actionable gene‐drug‐diagnosis group, 49.3% had a diagnosis where the drug was a therapeutic option and PGx could be used to guide treatment selection. Among patients with an associated diagnosis, 30.9% had a prescription for the actionable drug allowing PGx guided dosing. Three genes (CYP2C19, CYP2D6, and CYP3A5) accounted for all the gene‐drug‐diagnosis groups with matching diagnoses and prescriptions. The most common gene‐drug‐diagnosis groups with matching diagnoses and prescriptions were CYP2C19‐citalopram‐escitalopram‐depression 3.3% of patients tested; CYP2C19‐dexlansoprazole‐gastritis‐esophagitis 3.1%; CYP2C19‐omeprazole‐gastritis‐esophagitis 2.4%; CYP2D6‐atomoxetine‐attention deficit hyperactivity disorder 2.2%; and CYP2C19‐citalopram‐escitalopram‐obsessive‐compulsive disorder 1.5%. PGx could be used to guide selection of current treatment options or medication dosing in almost half (48.7%) of pediatric patients tested. Mood disorders and gastritis/esophagitis are promising targets for future study of PGx testing because of the high prevalence of these diagnoses and associated actionable gene‐drug pairs in the pediatric population. |
format | Online Article Text |
id | pubmed-7877836 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-78778362021-02-18 Retrospective Review of Pharmacogenetic Testing at an Academic Children’s Hospital Roberts, Timothy A. Wagner, Jennifer A. Sandritter, Tracy Black, Benjamin T. Gaedigk, Andrea Stancil, Stephani L. Clin Transl Sci Research There is limited evidence to support pharmacogenetic (PGx) testing in children. We conducted a retrospective review of PGx testing among 452 patients at an academic children’s hospital to determine the potential utility of PGx in diseases of childhood and to identify targets for future pediatric pharmacogenetic research. An actionable gene‐drug pair associated with the 28 genes tested (Clinical Pharmacogenetics Implementation Consortium (CPIC) level A or B, Pharmacogenomics Knowledge Base (PharmGKB) level 1A or B, or US Food and Drug Administration (FDA) recommendation and a PharmGKB level) was present in 98.7% of patients. We identified 203 actionable gene‐drug‐diagnosis groups based on the indications for each actionable drug listed in Lexicomp. Among patients with an actionable gene‐drug‐diagnosis group, 49.3% had a diagnosis where the drug was a therapeutic option and PGx could be used to guide treatment selection. Among patients with an associated diagnosis, 30.9% had a prescription for the actionable drug allowing PGx guided dosing. Three genes (CYP2C19, CYP2D6, and CYP3A5) accounted for all the gene‐drug‐diagnosis groups with matching diagnoses and prescriptions. The most common gene‐drug‐diagnosis groups with matching diagnoses and prescriptions were CYP2C19‐citalopram‐escitalopram‐depression 3.3% of patients tested; CYP2C19‐dexlansoprazole‐gastritis‐esophagitis 3.1%; CYP2C19‐omeprazole‐gastritis‐esophagitis 2.4%; CYP2D6‐atomoxetine‐attention deficit hyperactivity disorder 2.2%; and CYP2C19‐citalopram‐escitalopram‐obsessive‐compulsive disorder 1.5%. PGx could be used to guide selection of current treatment options or medication dosing in almost half (48.7%) of pediatric patients tested. Mood disorders and gastritis/esophagitis are promising targets for future study of PGx testing because of the high prevalence of these diagnoses and associated actionable gene‐drug pairs in the pediatric population. John Wiley and Sons Inc. 2020-10-15 2021-01 /pmc/articles/PMC7877836/ /pubmed/33048453 http://dx.doi.org/10.1111/cts.12895 Text en © 2020 The Authors. Clinical and Translational Science published by Wiley Periodicals LLC on behalf of the American Society for Clinical Pharmacology and Therapeutics. This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
spellingShingle | Research Roberts, Timothy A. Wagner, Jennifer A. Sandritter, Tracy Black, Benjamin T. Gaedigk, Andrea Stancil, Stephani L. Retrospective Review of Pharmacogenetic Testing at an Academic Children’s Hospital |
title | Retrospective Review of Pharmacogenetic Testing at an Academic Children’s Hospital |
title_full | Retrospective Review of Pharmacogenetic Testing at an Academic Children’s Hospital |
title_fullStr | Retrospective Review of Pharmacogenetic Testing at an Academic Children’s Hospital |
title_full_unstemmed | Retrospective Review of Pharmacogenetic Testing at an Academic Children’s Hospital |
title_short | Retrospective Review of Pharmacogenetic Testing at an Academic Children’s Hospital |
title_sort | retrospective review of pharmacogenetic testing at an academic children’s hospital |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7877836/ https://www.ncbi.nlm.nih.gov/pubmed/33048453 http://dx.doi.org/10.1111/cts.12895 |
work_keys_str_mv | AT robertstimothya retrospectivereviewofpharmacogenetictestingatanacademicchildrenshospital AT wagnerjennifera retrospectivereviewofpharmacogenetictestingatanacademicchildrenshospital AT sandrittertracy retrospectivereviewofpharmacogenetictestingatanacademicchildrenshospital AT blackbenjamint retrospectivereviewofpharmacogenetictestingatanacademicchildrenshospital AT gaedigkandrea retrospectivereviewofpharmacogenetictestingatanacademicchildrenshospital AT stancilstephanil retrospectivereviewofpharmacogenetictestingatanacademicchildrenshospital |