Pharmacogenomics: Bridging the Gap Between Genetics and Drug Therapy

Pharmacogenomics, the integration of pharmacology and genomics, lies at the center of precision medicine by personalizing drug therapy based on genetics. 20–95% of drug response variability arises due to genetic variation, which influences drug metabolism, transport, target, and immune reactions. Adverse drug reactions (ADRs), a leading cause of hospitalization and death, make personalized prescribing critical. There are a number of major pharmacogenomic applications, including cardiology dosing of warfarin and clopidogrel, cancer treatment targeted to a specific cancer, psychiatric medication optimization, and prevention of hypersensitivity to drugs like abacavir and carbamazepine. CPIC and DPWG recommendations aid clinical application, with issues of test availability, provider education, ethical issues, and patient heterogeneity persisting. Pharmacogenomic testing may be costly initially but is cost-effective by avoiding hospitalization and maximizing treatment. Technological advances in AI, CRISPR, and whole-genome sequencing hold the potential for greater incorporation into medicine. Pharmacogenomics is a new model for therapeutics that allows for safer, more efficient, and individualized medicine, with global efforts in place to provide equitable access.