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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Pharmacokinetics of bupropion and its pharmacologically active metabolites in pregnancy
Valentina M. Fokina,Meixiang Xu,Erik Rytting,Sherif Z. Abdel-Rahman,Holly West,Cheryl Oncken,Shannon M. Clark,Mahmoud Ahmed,Gary D.V. Hankins,Tatiana N. Nanovskaya +9 more
TL;DR: It is reported that the isoform-specific effect of pregnancy on bupropion-metabolizing enzymes along with the increase of renal elimination of the drug could collectively result in a slight decrease in exposure to buPropion in pregnancy.
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Optimizing clopidogrel dose response: a new clinical algorithm comprising CYP2C19 pharmacogenetics and drug interactions.
TL;DR: All patients under clopidogrel treatment, whose genotypes are different from *1*1, and concomitantly taking other drugs metabolized by CYP2C19 require clopIDogrel dose adjustment, and a new clinical-pharmacogenetic algorithm developed based on this data has the potential to maximize the benefit of clopidoogrel pharmacological therapy.
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Clinical Utility of CYP2C19 Genotype-Guided Antiplatelet Therapy in Patients at Risk of Adverse Cardiovascular and Cerebrovascular Events: A Review of Emerging Evidence.
Megan N. Gower,Lindsay R Ratner,Alexis K. Williams,Joseph S. Rossi,George A. Stouffer,Craig R. Lee +5 more
TL;DR: Evaluating the impact of CYP2C19 genotype-guided selection of antiplatelet therapy on clinical outcomes, summarizing emerging data from cardiovascular and neurology clinical studies, and discussing implications for clinical practice guidelines, remaining knowledge gaps and future research directions.
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