Clinical Pharmacogenetics Implementation Consortium Guidelines for CYP2C19 Genotype and Clopidogrel Therapy: 2013 Update
Stuart A. Scott,Katrin Sangkuhl,Charles M. Stein,Jean-Sébastien Hulot,Jean-Sébastien Hulot,Jessica L. Mega,Dan M. Roden,Teri E. Klein,Marc S. Sabatine,Julie A. Johnson,Julie A. Johnson,Alan R. Shuldiner,Alan R. Shuldiner +12 more
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TLDR
In this article, an expanded literature review showed that CYP2C19 loss-of-function alleles confer increased risks for serious adverse cardiovascular (CV) events among clopidogrel-treated patients with acute coronary syndromes (ACSs) undergoing percutaneous coronary intervention (PCI).Abstract:
Cytochrome P450 (CYP)2C19 catalyzes the bioactivation of the antiplatelet prodrug clopidogrel, and CYP2C19 loss-of-function alleles impair formation of active metabolites, resulting in reduced platelet inhibition. In addition, CYP2C19 loss-of-function alleles confer increased risks for serious adverse cardiovascular (CV) events among clopidogrel-treated patients with acute coronary syndromes (ACSs) undergoing percutaneous coronary intervention (PCI). Guideline updates include emphasis on appropriate indication for CYP2C19 genotype–directed antiplatelet therapy, refined recommendations for specific CYP2C19 alleles, and additional evidence from an expanded literature review (updates at http://www.pharmgkb.org).read more
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New aspects on efficient anticoagulation and antiplatelet strategies in sheep
Annika Weigand,Anja M. Boos,Jürgen Ringwald,Maren Mieth,Ulrich Kneser,Ulrich Kneser,Andreas Arkudas,Oliver Bleiziffer,Dorothee Klumpp,Dorothee Klumpp,Raymund E. Horch,Justus P. Beier +11 more
TL;DR: High dosages of clopidogrel inhibited platelet aggregation merely in a low number of sheep despite sufficient absorption, and ticagrelor and acetylsalicylic acid cannot be recommended for platelet inhibition in sheep.
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Cost-utility analysis of genotype-guided antiplatelet therapy in patients with moderate-to-high risk acute coronary syndrome and planned percutaneous coronary intervention
Vardhaman Patel,Fang-Ju Lin,Olaitan Ojo,Sapna Rao,Shengsheng Yu,Lin Zhan,Daniel R. Touchette +6 more
TL;DR: Net monetary benefit curves showed that genotype-guided therapy had at least 70% likelihood of being the most cost-effective alternative at a willingness-to-pay of USD100,000/QALY, and in comparison with clopidogrel, prasugrel therapy was more cost- effective with <21% certainty at willingness to pay of >USD170,000/.
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Is personalized medicine a dream or a reality
Bridget L. Morse,Richard B. Kim +1 more
TL;DR: It is shown, for a number of drugs in clinical use, that genomics-guided treatment options not only are becoming feasible but are also on the cusp of showing superiority in terms of clinical outcomes as well as cost-benefit.
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The genetic basis of antiplatelet and anticoagulant therapy: A pharmacogenetic review of newer antiplatelets (clopidogrel, prasugrel and ticagrelor) and anticoagulants (dabigatran, rivaroxaban, apixaban and edoxaban).
TL;DR: The genetic basis for traditional antiplatelets and the pharmacogenetics of warfarin is compared with the newer direct oral anticoagulant drugs in detail and strengths and weaknesses in the research thus far are identified.
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Genetic Testing in Clinical Settings
TL;DR: Because the understanding of genetic factors associated with disease and drug response is rapidly increasing and new genetic tests are being developed that could be adopted by clinicians in the short term, this In Practice review provides extensive resources for information and education on genetic testing.
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