Abstract
Introduction Expert groups have created dosing guidelines to
facilitate the implementation of pharmacogenetic knowledge into clinical
practice and commercial pharmacogenetic tests are becoming increasingly
accessible. However, the extent to which these commercial tests facilitate
the implementation of dosing guidelines is not clear.
Methods Gene-drug pairs included on 22 commercial pharmacogenetic
test panels were extracted and cross-referenced with the 74 gene-drug pairs
with dosing guidelines in the Pharmacogenetics Knowledgebase, with
particular attention given to the 28 gene-drug pairs relevant to
psychiatry.
Results On average, 70% of the 28 gene-drug pairs most
relevant to psychiatry were covered by the examined tests. Six gene-drug
pairs (CYP2D6-venlafaxine, CYP2D6-paroxetine,
CYP2D6-amitriptyline, CYP2C19-sertraline,
CYP2C19-citalopram, CYP2C19-amitriptyline) were included by
all tests. Gene-drug pairs included on less than half of the test panels
included HLA-B-phenytoin (14%), HLA-A-carbamazepine
(24%), HLA-B-carbamazepine (29%), and
CYP2D6-zuclopenthixol (43%).
Discussion Most commercial pharmacogenetic tests we examined are
well-equipped to facilitate implementation of the majority of dosing
guidelines relevant to psychiatry but are limited in their ability to
facilitate implementation of the full spectrum of dosing guidelines
currently available.
Key words
decision support tools - gene-drug interaction - translation
