291 results match your criteria pgx testing

Recommendations for Clinical CYP2D6 Genotyping Allele Selection: A Joint Consensus Recommendation of the Association for Molecular Pathology, College of American Pathologists, Dutch Pharmacogenetics Working Group of the Royal Dutch Pharmacists Association, and European Society for Pharmacogenomics and Personalized Therapy.

J Mol Diagn 2021 Jun 9. Epub 2021 Jun 9.

The Pharmacogenomics (PGx) Working Group of the Clinical Practice Committee*, Association for Molecular Pathology (AMP), Rockville, MD; Department of Pathology and Laboratory Medicine and Department of Genetics, University of North Carolina, Chapel Hill, NC.

The goals of the Association for Molecular Pathology (AMP) Clinical Practice Committee's Pharmacogenomics (PGx) Working Group are to define the key attributes of pharmacogenetic alleles recommended for clinical testing and determine a minimum set of variants that should be included in clinical PGx genotyping assays. This document series provides recommendations for a minimum panel of variant alleles ("Tier 1") and an extended panel of variant alleles ("Tier 2") that will aid clinical laboratories when designing assays for PGx testing. The AMP PGx Working Group considered functional impact of the variant alleles, allele frequencies in multiethnic populations, the availability of reference materials, as well as other technical considerations for PGx testing when developing these recommendations. Read More

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Analytical validation of a laboratory-development multigene pharmacogenetic assay.

Pharmacogenet Genomics 2021 Jun 9. Epub 2021 Jun 9.

Pharmacogenetic Laboratory, Genetics Department, Hospital Universitario La Paz Experimental Therapies and Novel Biomarkers in Cancer. IdiPAZ Clinical Pharmacology Department, School of Medicine, Hospital Universitario La Paz. IdiPAZ. Universidad Autónoma de Madrid Biostatistics Unit, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain.

Objective: The implementation of pharmacogenetics (PGx) in clinical practice is an essential tool for personalized medicine. However, clinical laboratories must validate their procedures before being used to perform PGx studies in patients, in order to confirm that they are adequate for the intended purposes.

Methods: We designed a validation process for our in-house pharmacogenetic PCR-based method assay. Read More

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Physicians' Knowledge and Attitudes Regarding Point-of-Care Pharmacogenetic Testing: A Hospital-Based Cross-Sectional Study.

Pharmgenomics Pers Med 2021 1;14:655-665. Epub 2021 Jun 1.

Department of Public Health, Jordan University of Science and Technology, Irbid, 22110, Jordan.

Introduction: Pharmacogenetic testing (PGx) is a diagnostic technique used by physicians to determine the possible reactions of patients to drug treatment on the basis of their genetic makeup. The aim of this study was to determine the impact of physicians' awareness, attitudes, and sociodemographics on the adoption of point-of-care (POC) PGx testing as a diagnostic method, as well as the impact of their knowledge, attitudes, and sociodemographics on its adoption.

Methods: A cross-sectional survey of 200 physicians and medical trainees working at the Clinics of King Abdullah University Hospital in Jordan was performed. Read More

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Evaluation of the need for pharmacogenomics testing among physicians in the West Bank of Palestine.

Drug Metab Pers Ther 2021 Jun 4. Epub 2021 Jun 4.

Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine.

Objectives: Pharmacogenomics (PGx) testing optimizes pharmacotherapy and reduces interindividual variation in drug responses. However, it is still not implemented in clinical practice in the West Bank of Palestine (WBP). The aim of this study was to determine the need for PGx education and testing among physicians from different specialties in WBP. Read More

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Determining the potential clinical value of panel-based pharmacogenetic testing in patients with chronic pain or gastroesophageal reflux disease.

Pharmacogenomics J 2021 Jun 1. Epub 2021 Jun 1.

Department of Pharmacotherapy and Translational Research, College of Pharmacy, University of Florida, Gainesville, FL, USA.

We aimed to determine the potential value of panel-based pharmacogenetic (PGx) testing in patients with chronic pain or gastroesophageal reflux disease (GERD) who underwent single-gene PGx testing to guide opioid or proton pump inhibitor (PPI) therapy, respectively. Of 448 patients included (chronic pain, n = 337; GERD, n = 111), mean age was 57 years, 68% were female, and 73% were white. Excluding opiates for the pain cohort and PPIs for the GERD cohort, 76. Read More

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Implementing Pharmacogenomics Testing: Single Center Experience at Arkansas Children's Hospital.

J Pers Med 2021 May 11;11(5). Epub 2021 May 11.

Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, AR 72202, USA.

Pharmacogenomics (PGx) is a growing field within precision medicine. Testing can help predict adverse events and sub-therapeutic response risks of certain medications. To date, the US FDA lists over 280 drugs which provide biomarker-based dosing guidance for adults and children. Read More

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Pharmacogenetic-guided treatment of depression: real-world clinical applications, challenges and perspectives.

Clin Pharmacol Ther 2021 May 28. Epub 2021 May 28.

Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy.

Depression is a leading cause of disability worldwide and despite the availability of numerous antidepressants, the lack of standardised criteria to apply personalised prescription is still a major issue. Pharmacogenetic (PGx) markers in cytochrome P450 (CYP450) genes are already usable to guide antidepressant choice/titration according to clinical guidelines; they are an important step towards personalised psychiatry as they can reduce the time to identify an effective and tolerated treatment. Clinical application is still limited due to the financial and organisational challenges, but the number of services providing genotyping of pharmaco-genes is increasing, with encouraging projections of cost-effectiveness. Read More

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Pharmacogenomics in the United States Community Pharmacy Setting: The Clopidogrel- Example.

Pharmgenomics Pers Med 2021 18;14:569-577. Epub 2021 May 18.

Ferris State University, Department of Pharmaceutical Sciences, Big Rapids, MI, USA.

Pharmacogenomics (PGx) is expanding across health-care practice settings, including the community pharmacy. In the United States, models of implementation of PGx in the community pharmacy have described independent services and those layered on to medication therapy management. The drug-gene pair of clopidogrel- has been a focus of implementation of PGx in community pharmacy and serves as an example of the evolution of the application of drug-gene interaction information to help optimize drug therapy. Read More

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Assessment of the Implementation of Pharmacogenomic Testing in a Pediatric Tertiary Care Setting.

JAMA Netw Open 2021 May 3;4(5):e2110446. Epub 2021 May 3.

Division of Clinical Pharmacology and Toxicology, Department of Paediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.

Importance: Pharmacogenomic (PGx) testing provides preemptive pharmacotherapeutic guidance regarding the lack of therapeutic benefit or adverse drug reactions of PGx targeted drugs. Pharmacogenomic information is of particular value among children with complex medical conditions who receive multiple medications and are at higher risk of developing adverse drug reactions.

Objectives: To assess the implementation outcomes of a PGx testing program comprising both a point-of-care model that examined targeted drugs and a preemptive model informed by whole-genome sequencing that evaluated a broad range of drugs for potential therapy among children in a pediatric tertiary care setting. Read More

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Characterization of Reference Materials for CYP2C9, CYP2C19, VKORC1, CYP2C Cluster Variant, GGCX, and Other Pharmacogenetic Alleles with an Association for Molecular Pathology (AMP) Pharmacogenetics Working Group Tier 2 Status - A GeT-RM Collaborative Project.

J Mol Diagn 2021 May 18. Epub 2021 May 18.

Centers for Disease Control and Prevention, Atlanta Georgia. Electronic address:

Pharmacogenetic (PGx) testing is increasingly available from clinical and research laboratories. However, only a limited number of quality control and other reference materials (RMs) are currently available for many of the variants that are tested. The Association for Molecular Pathology PGx Work Group has published a series of papers recommending alleles for inclusion in clinical testing. Read More

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Chronic Anticholinergic Toxicity Discovered in a Pharmacogenomics, Polypharmacy Patient.

Sr Care Pharm 2021 Jun;36(6):304-310

Objective: To report a case of chronic anticholinergic toxicity in a referred, pharmacogenomics (PGx), polypharmacy patient.

Summary: The patient is a 67-year-old male who was referred to the polypharmacy service for a PGx consult. This patient has had episodic fever of unknown origin, general cutaneous vasodilation, tremors, jerks, and brain fogginess which have been unexplained. Read More

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The Potential Role of Pharmacogenomics in Optimizing Drug Regimens for Older People with Major Depressive Disorder.

Sr Care Pharm 2021 Jun;36(6):276-282

Major depressive disorder (MDD) is a mood disorder common in older individuals. While many clinical guidelines endorse the use of selective serotonin reuptake inhibitors (SSRIs) as first-line therapy in the treatment of MDD, the use of SSRIs in older populations can result in medication-related adverse events. The use of pharmacogenomic (PGx) testing as a personalized tool to determine optimal SSRI therapy could offer a means to decrease morbidity and improve overall quality of life in older people. Read More

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Pharmacogenomics (PGx) Patient with Mixed Levels of Actionable Variant Evidence.

Innov Pharm 2020 30;11(2). Epub 2020 Apr 30.

Mayo Clinic Florida.

Objective: To demonstrate the types of clinical recommendations a pharmacogenomics pharmacist may make to medical clinicians with regard to medication management to improve therapeutic outcomes based on varied levels of medical literature evidence.

Summary: This case demonstrates how a common type of patient seen in a pharmacist practice may present with a varied pharmacogenomic (PGx) profile, how they may benefit from PGx analysis, and how varying levels of medical literature evidence can be used with clinical decision making.

Conclusion: PGx testing can help avoid adverse drug reactions (ADRs) or medication inefficacy by assisting in the adjustment of current or future medication doses. Read More

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Deliberations about clinical pharmacogenetic testing in pediatric oncology.

Per Med 2021 May 11. Epub 2021 May 11.

Department of Pediatrics & BC Children's Hospital Research Institute, Division of Translational Therapeutics, University of British Columbia, Vancouver, BC V6H 3V4, Canada.

This article summarizes the background, content and outcomes of a special meeting that was convened among oncologists and scientists to discuss the role of pharmacogenetic (PGx) testing in pediatric clinical oncology practice. This meeting provided an opportunity for what the lead author (AM Issa) refers to as the 'voice of the clinician' dynamic to be amplified in order to better understand how personalized or precision medicine applications such as PGx testing are adopted and incorporated into clinical settings and what we can learn from the experiences of current and ongoing implementation PGx approaches to further the implementation of precision medicine applications in real-world environments. Group dynamics and clinical experience with PGx testing and return of results shaped the discussion. Read More

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Patients with geographic barriers to health care access are prescribed a higher proportion of drugs with pharmacogenetic testing guidelines.

Clin Transl Sci 2021 May 5. Epub 2021 May 5.

Department of Pharmacotherapy and Translational Research, College of Pharmacy, University of Florida, Gainesville, Florida, USA.

Pharmacogenetic (PGx) testing may be particularly beneficial in medically underserved populations by reducing the number of appointments required to optimize drug therapy and increasing the effectiveness of less expensive off-patent drugs. The objective of this study was to identify patient populations with poor health care access and assess prescribing trends for drugs with published PGx testing guidelines. We used electronic health record data from 67,753 University of Florida Health patients, geographic access scores calculated via the 2-step floating catchment area method, and a composite measure of socioeconomic status. Read More

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A prospective study to determine the clinical utility of pharmacogenetic testing of veterans with treatment-resistant depression.

J Psychopharmacol 2021 May 3:2698811211015224. Epub 2021 May 3.

Mental Health Service, VA San Diego Healthcare System, San Diego, CA, USA.

Background: Pharmacotherapies for depression are often ineffective and treatment-resistant depression (TRD) is common across bipolar disorder (BD), major depressive disorder (MDD), and post-traumatic stress disorder (PTSD). Patient genetic information can be used to predict treatment outcomes. Prospective studies indicate that pharmacogenetic (PGX) tests have utility in the treatment of depression. Read More

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Pharmacogenetics in Psychiatry: Perceived Value and Opinions in a Chilean Sample of Practitioners.

Front Pharmacol 2021 15;12:657985. Epub 2021 Apr 15.

Center for Genetics and Genomics, Instituto de Ciencias e Innovación en Medicina, Facultad de Medicina, Clínica Alemana Universidad Del Desarrollo, Santiago, Chile.

Use of pharmacogenetics (PGx) testing to guide clinical decisions is growing in developed countries. Published guidelines for gene-drug pair analysis are available for prescriptions in psychiatry, but information on their utilization, barriers, and health outcomes in Latin America is limited. As a result, this work aimed at exploring current use, opinions, and perceived obstacles on PGx testing among psychiatrists in Chile, via an online, anonymous survey. Read More

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Mapping the Educational Environment of Genomics and Pharmacogenomics in the United Arab Emirates: A Mixed-Methods Triangulated Design.

OMICS 2021 May 27;25(5):285-293. Epub 2021 Apr 27.

Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.

Pharmacogenomics (PGx) education is crucial to support the effective delivery of PGx services in any health care system. We mapped the current educational environment of genomics and PGx in the United Arab Emirates (UAE) and assessed the readiness of the accredited higher education system to move forward with the implementation of PGx in the country. We employed a mixed-methods triangulated approach to map the PGx educational environment in UAE. Read More

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Feasibility of preemptive pharmacogenetic testing in colorectal cancer patients within a community oncology setting.

J Oncol Pharm Pract 2021 Apr 15:10781552211005529. Epub 2021 Apr 15.

Essentia Health, Duluth, MN, USA.

Introduction: Pharmacogenetics, in hand with precision medicine in oncology, represents an opportunity to holistically tailor a patient's treatment regimen using both somatic and germline variants to improve efficacy and decrease toxicity. Colorectal cancer patients represent a population with frequent use of fluoropyrimidine and irinotecan and are an ideal opportunity for implementation of preemptive pharmacogenetics as evidence supports pharmacogenetic testing for and to reduce fluoropyrimidine and irinotecan toxicities.

Methods: This was a single arm proof-of-concept study at a large community-based health system. Read More

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Adolescent perceptions of pharmacogenetic testing.

Pharmacogenomics 2021 Apr 14;22(6):335-343. Epub 2021 Apr 14.

Division of Clinical Pharmacology, Toxicology & Therapeutic Innovation, Children's Mercy Kansas City, MO 64108, USA.

Despite the expansion of pharmacogenetics (PGx), the views of pediatric patients remain unknown. This study explores adolescents' understanding and perceptions of PGx testing. Adolescents who had PGx testing were interviewed and their electronic health records were reviewed. Read More

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Biobank Scale Pharmacogenomics Informs the Genetic Underpinnings of Simvastatin Use.

Clin Pharmacol Ther 2021 Apr 10. Epub 2021 Apr 10.

Division of Human Genetics, Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.

Studying drug-metabolizing enzymes, encoded by pharmacogenes, may inform biological mechanisms underlying the diseases for which a medication is prescribed. Until recently, pharmacogenes could not be studied at biobank scale. In 7,649 unrelated African-ancestry (AFR) and 326,214 unrelated European-ancestry (EUR) participants from the UK Biobank, we associated pharmacogene haplotypes from 50 genes with 265 (EUR) and 17 (AFR) medication use phenotypes using generalized linear models. Read More

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Sequence2Script: A Web-Based Tool for Translation of Pharmacogenetic Data Into Evidence-Based Prescribing Recommendations.

Front Pharmacol 2021 18;12:636650. Epub 2021 Mar 18.

Ushiosoft Corporation, Calgary, AB, Canada.

Pharmacogenomic (PGx) testing has emerged as an effective strategy for informing drug selection and dosing. This has led to an increase in the use of PGx testing in the clinic and has catalyzed the emergence of a burgeoning commercial PGx testing industry. However, not all PGx tests are equivalent in their approach to translating testing results into prescribing recommendations, due to an absence of regulatory standards. Read More

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Pharmacogenomic Biomarkers in US FDA-Approved Drug Labels (2000-2020).

J Pers Med 2021 Mar 4;11(3). Epub 2021 Mar 4.

Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Landmark Center, 401 Park Drive, Suite 401 East, Boston, MA 02215, USA.

Pharmacogenomics (PGx) is a key subset of precision medicine that relates genomic variation to individual response to pharmacotherapy. We assessed longitudinal trends in US FDA approval of new drugs labeled with PGx information. Drug labels containing PGx information were obtained from [email protected] and guidelines from PharmGKB were used to compare the actionability of PGx information in drug labels across therapeutic areas. Read More

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Potential Utility of Pre-Emptive Germline Pharmacogenetics in Breast Cancer.

Cancers (Basel) 2021 Mar 11;13(6). Epub 2021 Mar 11.

ARUP Institute for Clinical and Experimental Pathology, Salt Lake City, UT 84108, USA.

Patients with breast cancer often receive many drugs to manage the cancer, side effects associated with cancer treatment, and co-morbidities (i.e., polypharmacy). Read More

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Implementation of a pharmacist-provided pharmacogenomics service in an executive health program.

Am J Health Syst Pharm 2021 06;78(12):1094-1103

Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, CO,USA.

Purpose: We describe the implementation of a pharmacist-provided pharmacogenomics (PGx) service in an executive health program (EHP) at an academic medical center.

Summary: As interest in genomic testing grows, pharmacists have the opportunity to advance the use of PGx in EHPs, in collaboration with other healthcare professionals. In November 2018, a pharmacist-provided PGx service was established in the EHP at the University of Colorado Hospital. Read More

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Potentially actionable pharmacogenetic variants and symptom control medications in oncology.

Support Care Cancer 2021 Mar 24. Epub 2021 Mar 24.

Department of Supportive Oncology, Atrium Health Levine Cancer Institute, Charlotte, NC, USA.

Purpose: We estimated the prevalence of potentially actionable pharmacogenetic (PGx) variants related to symptom control medications (SCMs) based on institutional prescribing patterns and correlated presenting symptoms with SCM prescribing.

Methods: This was a retrospective study of adult ambulatory cancer patients undergoing electronic distress screening (EDS) within 90 days of intake to the cancer hospital. We estimated the proportion prescribed SCM(s) with PGx evidence within 90 days of intake. Read More

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Comparison of Decision Modeling Approaches for Health Technology and Policy Evaluation.

Med Decis Making 2021 05 18;41(4):453-464. Epub 2021 Mar 18.

Department of Biomedical Informatics, Vanderbilt University School of Medicine Vanderbilt University Medical Center, Nashville, TN, USA.

We discuss tradeoffs and errors associated with approaches to modeling health economic decisions. Through an application in pharmacogenomic (PGx) testing to guide drug selection for individuals with a genetic variant, we assessed model accuracy, optimal decisions, and computation time for an identical decision scenario modeled 4 ways: using 1) coupled-time differential equations (DEQ), 2) a cohort-based discrete-time state transition model (MARKOV), 3) an individual discrete-time state transition microsimulation model (MICROSIM), and 4) discrete event simulation (DES). Relative to DEQ, the net monetary benefit for PGx testing (v. Read More

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Pharmacometrics-Based Considerations for the Design of a Pharmacogenomic Clinical Trial Assessing Irinotecan Safety.

Pharm Res 2021 Apr 17;38(4):593-605. Epub 2021 Mar 17.

Department of Pharmacy, Uppsala University, Box 580, 75123, Uppsala, Sweden.

Purpose: Pharmacometric models provide useful tools to aid the rational design of clinical trials. This study evaluates study design-, drug-, and patient-related features as well as analysis methods for their influence on the power to demonstrate a benefit of pharmacogenomics (PGx)-based dosing regarding myelotoxicity.

Methods: Two pharmacokinetic and one myelosuppression model were assembled to predict concentrations of irinotecan and its metabolite SN-38 given different UGT1A1 genotypes (poor metabolizers: CL: -36%) and neutropenia following conventional versus PGx-based dosing (350 versus 245 mg/m (-30%)). Read More

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Pharmacogenomic testing for mental health (Part II): qualitative analysis of early adopter prescriber perceptions.

Per Med 2021 May 17;18(3):233-240. Epub 2021 Mar 17.

Department of Family Medicine, University of Michigan, Ann Arbor, MI 48104, USA.

We sought to explore how early adopters use pharmacogenomic (PGx) testing for treating depression and attention-deficit/hyperactivity disorder. Prescribers of the (Progenity, Inc., Ann Arbor, MI 48108, USA) test completed a phone survey assessing use of PGx testing for different scenarios. Read More

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Pharmacogenomic testing for mental health (Part I): documenting early adopter perceptions of use for eight scenarios.

Per Med 2021 May 17;18(3):223-232. Epub 2021 Mar 17.

Department of Family Medicine, University of Michigan, Ann Arbor, MI 48104, USA.

We sought to understand how early adopters used pharmacogenomic (PGx) testing for treating depression and attention deficient hyperactivity disorder (ADHD). We conducted a phone survey with prescribers who had previously ordered an (Progenity, Inc., MI, USA) test. Read More

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