Precision medicine for rheumatologists: lessons from the pharmacogenomics of azathioprine.
Precision medicine for rheumatologists: lessons from the pharmacogenomics of azathioprine.
复制标题
DOI：
10.1007/s10067-020-05258-2
复制
发表时间：
2021-01
影响因子：
3.4
通讯作者：
Chung CP
中科院分区：
文献类型：
--
作者：
Daniel LL;Dickson AL;Chung CP
精准医学旨在为有效性和安全性提供个性化治疗。作为这一新兴举措的一个重要组成部分，药物基因组学旨在指导基于遗传学的药物治疗。在这篇综述文章中，我们给出了一个概述的药物基因组学的免疫抑制剂的风湿病学家，硫唑嘌呤。硫唑嘌呤的治疗指数较窄，不良事件的风险较高。通过应用候选基因分析和无偏方法，研究人员已经确定了与硫唑嘌呤相关的不良事件风险增加相关的多种变体，特别是骨髓抑制。TPMT和NUDT 15这两个基因的变体得到了广泛认可，导致药物监管机构和专业组织在开始硫唑嘌呤治疗前采用了检测建议。随着更多的基因-药物相互作用被发现，我们的领域将继续面临平衡与基因检测相关的利益和成本的挑战。然而，基因组学的新方法以及临床和遗传因素与风险评分的整合为药物基因组学在常规实践中的应用提供了前所未有的机会。
Precision Medicine aims to personalize treatment for both effectiveness and safety. As a critical component of this emerging initiative, pharmacogenomics seeks to guide drug treatment based on genetics. In this review article, we give an overview of pharmacogenomics in the setting of an immunosuppressant frequently prescribed by rheumatologists, azathioprine. Azathioprine has a narrow therapeutic index and a high risk of adverse events. By applying candidate gene analysis and unbiased approaches, researchers have identified multiple variants associated with an increased risk for adverse events associated with azathioprine, particularly bone marrow suppression. Variants in two genes, TPMT and NUDT15, are widely recognized, leading drug regulatory agencies and professional organizations to adopt recommendations for testing before initiation of azathioprine therapy. As more gene-drug interactions are discovered, our field will continue to face the challenge of balancing benefits and costs associated with genetic testing. However, novel approaches in genomics and the integration of clinical and genetic factors into risk scores offer unprecedented opportunities for the application of pharmacogenomics in routine practice.
登录
查看更多内容
影响因子：
7.6
作者：
Broekman MMTJ;Coenen MJH;Wanten GJ;van Marrewijk CJ;Klungel OH;Verbeek ALM;Hooymans PM;Guchelaar HJ;Scheffer H;Derijks LJJ;Wong DR;de Jong DJ
通讯作者：
de Jong DJ
影响因子：
3.2
作者：
Cao, Qian;Zhu, Qin;Si, Jianmin
通讯作者：
Si, Jianmin
影响因子：
3.8
作者：
Andonova, Irena E.;Justenhoven, Christina;Brauch, Hiltrud
通讯作者：
Brauch, Hiltrud
影响因子：
105.7
作者：
CURREY, HLF;HARRIS, J;OWENSMIT.B
通讯作者：
OWENSMIT.B
影响因子：
6.7
作者：
通讯作者：
--