Pharmacogenomics and Personalized Medicine (Jan 2017)

Prevalence of clinically actionable genotypes and medication exposure of older adults in the community

  • Daneshi N,
  • Holliday E,
  • Hancock S,
  • Schneider JJ,
  • Scott RJ,
  • Attia J,
  • Milward EA

Journal volume & issue
Vol. Volume10
pp. 17 – 27

Abstract

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Nilofar Daneshi,1,2 Elizabeth Holliday,3,4 Stephen Hancock,3,4 Jennifer J Schneider,1,2 Rodney J Scott,1,2,5 John Attia,3,4 Elizabeth A Milward1,2 1Faculty of Health and Medicine, School of Biomedical Sciences and Pharmacy, 2Faculty of Health and Medicine, Centre for Bioinformatics, Biomarker Discovery and Information-Based Medicine, The University of Newcastle, Callaghan, 3Clinical Research Design, IT and Statistical Support Unit, Hunter Medical Research Institute, 4Centre for Clinical Epidemiology and Biostatistics, School of Medicine and Public Health, Faculty of Health, University of Newcastle, 5Hunter Area Pathology Service, John Hunter Hospital, Newcastle, NSW, Australia Abstract: 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, ~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. Keywords: actionable genotype, community, older adults, pharmacogenomics, pre-emptive genotyping, single-nucleotide polymorphism

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