Prevalence of clinically actionable genotypes and medication exposure of older adults in the community
Prevalence of clinically actionable genotypes and medication exposure of older adults in the community
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DOI：
10.2147/pgpm.s123719
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发表时间：
2017-01-01
影响因子：
1.9
通讯作者：
Milward, Elizabeth A.
中科院分区：
文献类型：
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作者：
Daneshi, Nilofar;Holliday, Elizabeth;Milward, Elizabeth A.
本研究使用来自澳大利亚猎人社区研究（HCS）的2121名参与者（55-85岁）的微阵列数据分析了氯吡格雷、华法林、他汀类药物、硫嘌呤和他克莫司的临床可操作药物基因型。至少74%的受试者（95%置信区间[CI]：72%-76%）有强有力的证据表明，至少有一种中等或高风险的可采取行动的基因型，根据目前的国际建议，这将触发标准治疗的变化。这些参与者中约有14%（95% CI：12%-16%）正在服用可能受基因型影响的药物。此外，在所有有药物数据的参与者中，有2.6%（95% CI：1.4%-3.8%）的参与者对于他们暴露的药物具有高风险临床可操作基因型。这在人口一级代表了相当多的人。尽管基因型与健康结果之间的关系仍然存在争议，但同时对多种变体进行药物基因分型可能具有相当大的潜力，可以提高社区老年人的用药安全性和疗效。
This study analyzed clinically actionable pharmacogenotypes for clopidogrel, warfarin, statins, thiopurines, and tacrolimus using microarray data for 2121 participants (55-85 years) from the Australian Hunter Community Study (HCS). At least 74% of participants (95% confidence interval [CI]: 72%-76%) had strong level evidence for at least one medium-or high-risk actionable genotype that would trigger a change in standard therapy under current international recommendations. About 14% of these participants (95% CI: 12%-16%) were taking medication potentially affected by the genotype in question. Furthermore, similar to 2.6% of all participants with medication data (95% CI: 1.4%-3.8%) had a high-risk clinically actionable genotype for a medication to which they were exposed. This represents a considerable number of people at the population level. Although relationships between genotype and health outcomes remain contentious, pharmacogenotyping of multiple variants simultaneously may have considerable potential to improve medication safety and efficacy for older people in the community.