Authors' reply

摘要

Young-Hoon Jeong and colleagues highlight the concept that the frequencies of CYP2C19 loss-of-function alleles vary between ethnic groups. Notably, carrier rates of CYP2C19*3 might exceed 15% in Asian people, whereas they are generally less than 1% in individuals of western European ancestry.12 We agree that incorporation of CYP2Q9*3 into a pharmacogenomic algorithm would probably prove beneficial in Asians. Furthermore, we would advocate inclusion of all CYP2C19 loss-of-function alleles and potentially ABCB1 3435 C^T in future large pharmacogenomic studies. We elected to focus exclusively on CYP2C19*2 in our proof-of-concept study owing to the projected negligible effect of the remaining rare alleles in our population. Indeed, retrospective genotyping revealed that no patients enrolled in ourtrial carried CYP2C19*3. In response to the suggestions that the threshold for high on-treatment platelet reactivity and the therapeutic effect of prasugrel differ in Asians, we feel that these are interesting concepts that merit further investigation.