Key result
Asian populations exhibit distinct pharmacogenomic variant frequencies and associated clinical risks, such as a stronger risk of MACE with clopidogrel in CYP2C19 loss-of-function allele carriers.
Why the study?
Pharmacogenomic variants differ widely across ethnicities, and clinical outcomes associated with these variants may also be substantially varied.
Do pharmacogenomic variants and their associated clinical outcomes differ between Asian and other human populations?
Do pharmacogenomic variants and their associated clinical outcomes differ between Asian and other human populations?
Pharmacogenomic variants and their associated clinical risks, such as CYP2C19-related MACE with clopidogrel, differ significantly between Asian and Caucasian populations, highlighting the need for population-specific PGx implementation.
May inform clopidogrel choice in Asian patients; extends pharmacogenomic data but leaves practice change open pending RCTs.
Introduction Various pharmacogenomic (PGx) variants differ widely in different ethnicities. and clinical outcomes associated with these variants may also be substantially varied. Literature was searched in different databases, i.e. PubMed, ScienceDirect, Web of Science, and PharmGKB, from inception to 30 June 2022 for this review.Areas covered Certain PGx variants were distinctly varied in Asian populations compared to the other human populations, e.g. CYP2C19*2,*3,*17; CYP2C9*2,*3; CYP2D6*4,*5,*10,*41; UGT1A1*6,*28; HLA-B*15:02, HLA-B*15:21, HLA-B*58:01, and HLA-A*31:01. However, certain other variants do not vary greatly between Asian and other ethnicities, e.g. CYP3A5*3; ABCB1, and SLCO1B1*5. As evident in this review, the risk of major adverse cardiovascular events (MACE) was much stronger in Asian patients taking clopidogrel and who inherited the CYP2C19 loss-of-function alleles, e.g. CYP2C19*2 and*3, when compared to the western/Caucasian patients. Additionally, the risk of carbamazepine-induced severe cutaneous adverse drug reactions (SCARs) for the patients inheriting HLA-B*15:02 and HLA-B*15:21 alleles varied significantly between Asian and other ethnicities. In contrast, both Caucasian and Asian patients inheriting the SLCO1B1*5 variant possessed a similar magnitude of muscle toxicity, i.e. myopathy.Expert opinion Asian countries should take measures toward expanding PGx research, as well as initiatives for the purposes of obtaining clinical benefits from this newly evolving and economically viable treatment model.
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Biswas et al. (2023) conducted a review in Pharmacogenomic variants and associated clinical outcomes. Asian ethnicity and specific pharmacogenomic variants vs. Other ethnicities (e.g., Caucasian/Western populations) was evaluated on Differences in pharmacogenomic variants and associated clinical outcomes (e.g., MACE, SCARs, myopathy). Asian populations exhibit distinct pharmacogenomic variant frequencies and associated clinical risks, such as a stronger risk of MACE with clopidogrel in CYP2C19 loss-of-function allele carriers.
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