Pharmacogenomics and Personalized Medicine (Nov 2022)
Utilizing Pharmacogenomics Results to Determine Opioid Appropriateness and Improve Pain Management in a Patient with Osteoarthritis
Abstract
Katie Pizzolato,1 David Thacker,2 Nicole Marie Del Toro-Pagán,1 Nishita S Amin,1 Abeer Hanna,3 Jacques Turgeon,2,4 Veronique Michaud2,4,5 1Tabula Rasa Healthcare, Office of Translational Research and Residency Programs, Moorestown, NJ, 08057, USA; 2Tabula Rasa HealthCare, Precision Pharmacotherapy Research and Development Institute, Orlando, FL, 32827, USA; 3VieCare Butler, Program of All-Inclusive Care for the Elderly (PACE), Butler, PA, 16001, USA; 4Faculty of Pharmacy, Université de Montréal, Montréal, QC, H2L, Canada; 5University of Montreal Hospital Research Center (CRCHUM), Montréal, QC, H2X 0A9, CanadaCorrespondence: Veronique Michaud, Precision Pharmacotherapy Research and Development Institute, 13485 Veterans Way, Orlando, FL, 32827, USA, Tel +856-938-8697, Email [email protected]: The opioid epidemic in the United States has exposed the need for providers to limit opioid dispensing and identify at-risk patients prior to prescribing opioids. With pharmacogenomic testing, clinicians can analyze hundreds of medications—including commonly prescribed opioids—against genetic results to understand and predict risk and response. Moreover, knowledge of genotypic variants and altered function can help decrease trial and error prescribing, identify patients at-risk for adverse drug events, and improve pain control. This patient case demonstrates how pharmacogenomic test results identified drug–gene interactions and provided insight about a patient’s inadequate opioid therapy response. With pharmacogenomic information, the patient’s healthcare team discontinued opioid therapy and selected a more appropriate regimen for osteoarthritis (ie, celecoxib), resulting in improved pain control and quality of life.Keywords: CYP2D6, CYP2C9, drug–gene interactions, opioids, pain management, pharmacogenomics
