What do we need to transfer pharmacogenetics findings into the clinic?

In an ideal world, individual genetic information should be integrated in computer provider order entry (CPOE) systems and/or clinical decision support tools to calculate precise dosing regimens or to establish effectivity or risks of treatment before physicians generate electronic prescriptions. Ac...

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Bibliographic Details
Published in:	Pharmacogenomics Vol. 19; no. 7; pp. 589 - 592
Main Authors:	Slob, Elise MA, Vijverberg, Susanne JH, Pijnenburg, Mariëlle W, Koppelman, Gerard H, der Zee, Anke-Hilse Maitland-van
Format:	Journal Article
Language:	English
Published:	England Future Medicine Ltd 01-05-2018
Subjects:	Asthma Breast feeding Clinical medicine Clinical trials Codeine Computerized physician order entry Consortia CYP2D6 protein Cytochrome P450 Decision Support Systems, Clinical Drug dosages Electronic Health Records Genetic diversity Genotype & phenotype Genotypes Humans implementation Infrastructure Patients Pharmacogenetics Pharmacogenetics - methods Pharmacogenetics - trends Point-of-Care Testing - organization & administration Point-of-Care Testing - trends Precision medicine Precision Medicine - methods Precision Medicine - trends Prescription drugs Public health SWOT analysis Validity precision medicine infrastructure pharmacogenetics implementation
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Summary:	In an ideal world, individual genetic information should be integrated in computer provider order entry (CPOE) systems and/or clinical decision support tools to calculate precise dosing regimens or to establish effectivity or risks of treatment before physicians generate electronic prescriptions. According to the clinical evidence pyramid, most weight is given to randomized controlled trials (RCTs) that compare pharmacogenetic-guided treatment strategy to usual care. [...]in case of strong observational evidence of genetic variants associated with life-threatening drug-induced toxicities (3), such as CYP2D6 genotype of breastfeeding mothers and codeine-induced neonate mortality (4). [...]it is important to reach consensus what level of evidence is needed to change clinical practice when precision medicine RCTs are not feasible or ethical. [...]we are moving onward towards implementation of pharmacogenetics into clinical practice.
Bibliography:	SourceType-Other Sources-1 content type line 63 ObjectType-Editorial-2 ObjectType-Commentary-1
ISSN:	1462-2416 1744-8042
DOI:	10.2217/pgs-2018-0026