Why the study?
What is the prevalence of clinically actionable pharmacogenotypes and concurrent medication exposure in older adults in the community?
What is the prevalence of clinically actionable pharmacogenotypes and concurrent medication exposure in older adults in the community?
A significant proportion of older adults in the community possess clinically actionable pharmacogenotypes, highlighting the potential of preemptive pharmacogenomic testing to improve medication safety.
May inform preemptive pharmacogenomic testing in older adults; hypothesis-generating and should not yet change practice.
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.
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Daneshi et al. (2017) studied this question.
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