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The American Journal of Psychiatry Oct 2017
Topics: Adult; Antipsychotic Agents; Clinical Decision-Making; Clozapine; Humans; Male; Pharmacogenetics; Pharmacogenomic Testing; Schizophrenia
PubMed: 28965468
DOI: 10.1176/appi.ajp.2017.16121353 -
Pharmacogenomics Apr 2020To investigate the current state of TPMT testing at a single-academic medical center. Single-center, retrospective chart review for patients newly prescribed a...
To investigate the current state of TPMT testing at a single-academic medical center. Single-center, retrospective chart review for patients newly prescribed a thiopurine. Data collection and evaluation included the prevalence and timing of TPMT testing, correct dosage adjustment if applicable, and incidence of myelosuppression. 121 patients (71%) received TPMT testing. Out of the tested patients, 110 (90.9%) were designated as wild-type with normal metabolism. Dosing modification was appropriate in applicable patients. In unadjusted analysis, there was a lower incidence of myelosuppression among patients who were tested versus those who were not (16.5 vs 36.7%). Based on the study results, TPMT testing opportunities exist for nearly 30% of patients. Testing may reduce the incidence of myelosuppression.
Topics: Adult; Aged; Azathioprine; Delivery of Health Care; Female; Humans; Male; Mercaptopurine; Methyltransferases; Middle Aged; North Carolina; Pharmacogenetics; Pharmacogenomic Testing; Retrospective Studies
PubMed: 32308127
DOI: 10.2217/pgs-2019-0148 -
The Journal of Molecular Diagnostics :... Sep 2023
Topics: Humans; Pharmacogenomic Testing; Genetic Testing; Pharmacogenetics
PubMed: 37481236
DOI: 10.1016/j.jmoldx.2023.07.001 -
Journal of Clinical Oncology : Official... Aug 2023
Topics: Humans; Pharmacogenomic Testing; Informed Consent; Pharmacogenetics; Genetic Testing
PubMed: 37267582
DOI: 10.1200/JCO.23.00664 -
Pharmacogenomics Jun 2020Evaluate the cost-effectiveness of combinatorial pharmacogenomic (PGx) testing, versus treatment as usual (TAU), to guide treatment for patients with depression, from...
Evaluate the cost-effectiveness of combinatorial pharmacogenomic (PGx) testing, versus treatment as usual (TAU), to guide treatment for patients with depression, from the Canadian public healthcare system perspective. Clinical and economic data associated with depression were extracted from published literature. Clinical (quality-adjusted life years; QALYs) and economic (incremental cost-effectiveness ratio) outcomes were modeled using combinatorial PGx and TAU treatment strategies across a 5-year time horizon. With the combinatorial PGx strategy to guide treatment, patients were projected to gain 0.14-0.19 QALYs versus TAU. Accounting for test price, combinatorial PGx saved CAD $1,687-$3,056 versus TAU. Incremental cost-effectiveness ratios ranged from -$11,861 to -$16,124/QALY gained. Combinatorial PGx testing was more efficacious and less costly compared with the TAU for depression.
Topics: Canada; Cost-Benefit Analysis; Depression; Humans; National Health Programs; Pharmacogenomic Testing
PubMed: 32301648
DOI: 10.2217/pgs-2020-0012 -
Journal of Psychiatric Research Jul 2019
Topics: Depressive Disorder, Major; Humans; Pharmacogenetics; Pharmacogenomic Testing; Psychiatry; Research Design
PubMed: 30981422
DOI: 10.1016/j.jpsychires.2019.04.003 -
Clinical Advances in Hematology &... Sep 2020
Topics: Humans; Pharmacogenetics; Pharmacogenomic Testing; Precision Medicine
PubMed: 33006581
DOI: No ID Found -
Journal of Developmental and Behavioral... Jan 2020To describe drug prescribing and outcomes after pharmacogenomic (PGx) testing in children with developmental and/or behavioral disorders.
OBJECTIVE
To describe drug prescribing and outcomes after pharmacogenomic (PGx) testing in children with developmental and/or behavioral disorders.
METHODS
This is a single-clinic retrospective analysis of patients aged 5 to 17 years with documented behavioral and/or development disorder(s) and having received PGx testing between May 2015 and May 2017. The primary endpoint was frequency of PGx-guided medication changes after testing. Secondary endpoints included frequency of medications in each category from the PGx report (use as directed, use with caution, and use with increased caution), changes in therapy within each category, frequency and type of actionable genes, symptomatic improvement, and frequency of medication changes up to 6 months after PGx-guided therapy.
RESULTS
Of 200 patients, 75% were male, 78% were white, 83% had attention-deficit/hyperactivity disorder, and 45% had anxiety, and their mean age was 10 years. Most common reasons for ordering PGx testing were lack of response (83%) and/or adverse events (42%). Approximately 84% had PGx-guided medication change(s) after testing. At baseline, 50% of medications were categorized in "use as directed," 40% in "use with caution," and 11% in "use with increased caution." After testing, 8%, 29%, and 30% of medications in "use as directed," "use with caution," and "use with increased caution" categories were discontinued; 85% were added or continued from "use as directed" category. The most common actionable genes were ADRA2A (47%), COMT (22%), and CYP2D6 (20%). Sixty percent were on the same medication(s) suggested by the PGx report 6 months later, and 64% had provider-documented symptomatic improvement.
CONCLUSION
Pharmacogenomic testing may affect drug prescribing and clinical outcomes in a pediatric behavioral health clinic.
Topics: Adolescent; Child; Child, Preschool; Drug Prescriptions; Female; Humans; Male; Mental Disorders; Neurodevelopmental Disorders; Pharmacogenomic Testing; Retrospective Studies
PubMed: 31688658
DOI: 10.1097/DBP.0000000000000746 -
BMC Psychiatry May 2023Pharmacogenomic testing guided treatment have been developed to guide drug selection or conversion in major depressive disorder patients. Whether patients benefit from... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Pharmacogenomic testing guided treatment have been developed to guide drug selection or conversion in major depressive disorder patients. Whether patients benefit from pharmacogenetic testing remains unclear. We aim to evaluates the effect of pharmacogenomic testing guiding on clinical outcomes of major depressive disorder.
METHODS
Pubmed, Embase, and Cochrane Library of Clinical Trials were searched from inception until August 2022. Key terms included pharmacogenomic and antidepressive. Odds ratios (RR) with 95% confidence intervals (95%CIs) were calculated using fixed-effects model for low or moderate heterogeneity or random-effects model for high heterogeneity.
RESULTS
Eleven studies (5347 patients) were included. Compared with usual group, pharmacogenomic testing guided group was associated with an increased response rate at week 8 (OR 1.32, 95%CI 1.15-1.53, 8 studies, 4328 participants) and week 12 (OR 1.36, 95%CI 1.15-1.62, 4 studies, 2814 participants). Similarly, guided group was associated with an increased rate of remission at week 8 (OR 1.58, 95%CI 1.31-1.92, 8 studies, 3971 participants) and week 12 (OR 2.23, 95%CI 1.23-4.04, 5 studies, 2664 participants). However, no significant differences were found between the two groups in response rate at week 4 (OR 1.12, 95%CI 0.89-1.41, 2 studies, 2261 participants) and week 24 (OR 1.16, 95%CI 0.96-1.41, 2 studies, 2252 participants), and remission rate at week 4 (OR 1.26, 95%CI 0.93-1.72, 2 studies, 2261 participants) and week 24 (OR 1.06, 95%CI 0.83-1.34, 2 studies, 2252 participants). Medication congruence in 30 days was significantly reduced in the pharmacogenomic guided group compared with the usual care group (OR 2.07, 95%CI 1.69-2.54, 3 studies, 2862 participants). We found significant differences between subgroups of target population in response and remission rate.
CONCLUSION
Patients with major depressive disorder may benefit from pharmacogenomic testing guided treatment by achieving target response and remission rates more quickly.
Topics: Humans; Depressive Disorder, Major; Pharmacogenetics; Antidepressive Agents; Pharmacogenomic Testing; Odds Ratio; Randomized Controlled Trials as Topic
PubMed: 37173736
DOI: 10.1186/s12888-023-04756-2 -
Omics : a Journal of Integrative Biology Nov 2020Pharmacogenomics is rapidly assuming an integral part in modern health care. Still, its broad applicability relies on the feasibility of performing pharmacogenomic...
Pharmacogenomics is rapidly assuming an integral part in modern health care. Still, its broad applicability relies on the feasibility of performing pharmacogenomic testing in all clinical settings, including in remote areas or resource-limited settings with budget restrictions. In this study, we describe the development and feasibility of rapid and reliable pharmacogenomics assays using a portable molecular biology laboratory, namely the 2MoBiL (Mobile Molecular Biology Laboratory). More precisely, we demonstrate that the genotyping of rs4149056, located within , can be efficiently and reliably performed using the 2MoBiL portable laboratory and conventional benchtop laboratory equipment and a gold standard genotyping method (KASP assay) as directly comparable methodologies. Taking into account the compact size of 2MoBiL, which directly and positively impacts on its portability, and the high accuracy achieved, we conclude that the 2MoBiL-based genotyping method is warranted for further studies in clinical practices at remote areas and resource-limited as well as time-constrained planetary health settings. To contextualize the broader and potential future applications of 2MoBiL, we emphasize that genotyping of a limited set of clinically relevant single-nucleotide polymorphisms is often a common endpoint of genomics and pharmacogenomics discovery and translational research pipeline. Hence, rapid genotyping by 2MoBiL can be an essential catalyst for global implementation of pharmacogenomics and personalized medicine in the clinic. The Clinical Trial Registration number is NCT03093818.
Topics: Alleles; Genotyping Techniques; Humans; Laboratories; Mobile Health Units; Molecular Biology; Pharmacogenetics; Pharmacogenomic Testing; Translational Research, Biomedical; Workflow
PubMed: 33064577
DOI: 10.1089/omi.2020.0168