Key result
Clopidogrel pharmacogenetic testing carries stronger evidence than other AHA/ACC- or NCCN-recommended genetic tests.
Why the study?
Current guideline recommendations for pharmacogenetic testing for clopidogrel by AHA/ACC contradict other authorities and apply inconsistent standards compared to other pharmacogenetic tests.
Is the evidence supporting pharmacogenetic testing for clopidogrel stronger than for other tests recommended by guidelines?
Is the evidence supporting pharmacogenetic testing for clopidogrel stronger than for other tests recommended by guidelines?
Guidelines may hold pharmacogenetic testing for clopidogrel to an inconsistently higher standard compared to other recommended pharmacogenetic tests.
Indicates inconsistent evidentiary thresholds across AHA/ACC and NCCN recommendations; leaves open whether clopidogrel testing warrants prioritized guideline adoption in PCI.
Current guideline recommendations for pharmacogenetic testing for clopidogrel by the American Heart Association/American College of Cardiology (AHA/ACC) contradict the Clinical Pharmacogenetics Implementation Consortium and the US FDA. The AHA/ACC recommends against routine pharmacogenetic testing for clopidogrel because no randomized controlled trials have demonstrated that testing improves patients' outcomes. However the AHA/ACC and the National Comprehensive Cancer Network (NCCN) recommend other pharmacogenetic tests in the absence of randomized controlled trials evidence. Using clopidogrel as a case example, we compared the evidence for other pharmacogenetic tests recommended by the AHA/ACC and NCCN. In patients that received percutaneous coronary intervention, the evidence supporting pharmacogenetic testing for clopidogrel is stronger than other pharmacogenetic tests recommended by the AHA/ACC and NCCN.
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Luzum et al. (2018) conducted a review in Percutaneous coronary intervention. Pharmacogenetic testing for clopidogrel vs. Other pharmacogenetic tests recommended by AHA/ACC and NCCN was evaluated on Strength of evidence. The evidence supporting pharmacogenetic testing for clopidogrel in PCI patients is stronger than for other pharmacogenetic tests recommended by the AHA/ACC and NCCN.
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