Pharmacogenetic testing in the UK clinical setting

摘要

Pharmacogenetic studies grow in number and power, but translation of knowledge into the clinical setting has been slow. The USA leads the world in the use of genetic information to support decision making for drug prescription, but the use is far from routine. Recently the RAPID GENE study1 showed early proof-of-concept for the benefit of point-of-care genotyping of CYP2C19 to personalise antiplatelet therapy in patients undergoing percutaneous coronary intervention. This study built on a meta-analysis, showed poor efficacy of clopidogrel when a patient had CYP2C19*2 and CYP2C19*3 allele variants.2 The American Food and Drug Administration responded by releasing boxed warnings for clopidogrel. The UK has been slower in the adoption of genetic testing for drug therapy, with few laboratories offering the service and a limited number of tests being requested.