Pharmacogenomics and Personalized Medicine (Aug 2022)
Prescription Advice Based on Data of Drug-Drug-Gene Interaction of Patients with Polypharmacy
Abstract
Sandro Salamone,1 Sara Spirito,2 Maurizio Simmaco,2 Marius Unger,1 Saskia Preissner,3 Björn-Oliver Gohlke,1 Andreas Eckert,1 Robert Preissner1 1Science-IT and Institute of Physiology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany; 2Department of Neurosciences, Mental Health and Sensory Organs, Faculty of Medicine and Psychology, Sapienza University and Laboratory of Clinical Biochemistry, Sant’Andrea Hospital, Rome, Italy; 3Department Oral and Maxillofacial Surgery, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, GermanyCorrespondence: Robert Preissner, Science-IT and Institute of Physiology, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Philippstr. 12, Berlin, 10115, Germany, Tel +49 30 450 655 208, Fax +49 30 450 655 300, Email [email protected]: Pharmacogenetic counselling is a complex task and requires the efforts of an interdisciplinary team, which cannot be implemented in most cases. Therefore, simple rules could help to minimize the risk of medications incompatible with each other or with frequent genetic variants.Patients and Methods: One hundred and eighty-four multi-morbid Caucasian patients suffering from side effects or inefficient therapy were enrolled and genotyped. Their medication was analyzed by a team of specialists using Drug-PIN® (medication support system) and individual recommendations for 34 drug classes were generated.Results: In each of the critical drug classes, 50% of the drugs cannot be recommended to be prescribed in typical drug cocktails. PPIs and SSRI/SNRIs represent the most critical drug classes without showing a single favorable drug. Among the well-tolerated drugs (not recommended for less than 5% of the patients) are metamizole, celecoxib, olmesartan and famotidine. For each drug class, a ranking of active ingredients according to their suitability is presented.Conclusion: Genotyping and its profound analysis are not available in many settings today. The consideration of frequent alterations of metabolic elimination routes and drug–drug–gene interactions by using simple rankings can help to avoid many incompatibilities, side effects and inefficient therapies.Keywords: single nucleotide polymorphisms, personalized medicine, precision medicine, DDGIs, CYPs, transporter
