Key result
Loss-of-function CYP2C19 metabolizer phenotypes peak in Asia, affecting up to ~77% of East Asians.
Why the study?
Although global CYP2C19 variant prevalence is well described, CYP2C19 diplotype and metaboliser phenotype frequencies specifically in clopidogrel-indicated populations needed characterisation.
The high global prevalence of CYP2C19 intermediate and poor metabolisers in clopidogrel-indicated populations, particularly in East and South Asia, highlights a major opportunity for implementing pharmacogenomic-guided antiplatelet therapy.
Answers are grounded in this paper and cite their sources.
May inform regional clopidogrel PGx trials; extends global CYP2C19 metaboliser prevalence data.
Clopidogrel is a widely prescribed antiplatelet prodrug, with activation affected by CYP2C19 loss- and gain-of-function variants. Whilst global CYP2C19 variant prevalence is well described, this scoping review characterises CYP2C19 diplotype and metaboliser phenotype frequencies in clopidogrel-indicated populations. A literature search of Scopus, PubMed, Ovid MEDLINE, and Ovid Embase was conducted from inception to 6 July 2026. Forty-one studies (n = 18958) reporting CYP2C19 diplotypes were synthesised across Asia, the Middle East and North Africa (MENA), Europe and the Americas and converted to phenotypes. Intermediate and poor metabolisers were most prevalent in East Asia (54.0–77.2%) and South Asia (47.3–71.1%). Rapid and ultrarapid metabolisers were most prevalent in MENA (27.3–44.3%) and Europe (27.3–36.2%). Frequent diplotypes were *1/*2 in intermediate and *2/*2 in poor metabolisers. Overall, phenotype distribution reflects global population trends. High global prevalence of CYP2C19 intermediate and poor metabolisers amongst clopidogrel-indicated populations presents an opportunity to implement pharmacogenomic-guided prescribing.
No takes yet. Share an insight, caveat, or question.
Antonopoulos et al. (2026) conducted a review in Clopidogrel-indicated populations (n=18,958). CYP2C19 loss- and gain-of-function variants was evaluated on CYP2C19 diplotype and metaboliser phenotype frequencies. CYP2C19 intermediate/poor metabolizers were most prevalent in East Asia (54.0-77.2%) and South Asia (47.3-71.1%), while rapid/ultrarapid were highest in MENA (27.3-44.3%) and Europe (27.3-36.2%).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: