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Article

Clinical Relevance of a 16-Gene Pharmacogenetic Panel Test for Medication Management in a Cohort of 135 Patients

by
David F. Niedrig
1,2,
Ali Rahmany
1,3,
Kai Heib
4,
Karl-Dietrich Hatz
4,
Katja Ludin
5,
Andrea M. Burden
3,
Markus Béchir
6,
Andreas Serra
7 and
Stefan Russmann
1,3,7,*
1
Drugsafety.ch, 8703 Kusnacht, Switzerland
2
Hospital Pharmacy, Clinic Hirslanden Zurich, 8032 Zurich, Switzerland
3
Swiss Federal Institute of Technology Zurich (ETHZ), 8093 Zurich, Switzerland
4
INTLAB AG, 8707 Uetikon am See, Switzerland
5
Labor Risch, Molecular Genetics, 3097 Berne, Switzerland
6
Center for Internal Medicine, Clinic Hirslanden Aarau, 5001 Aarau, Switzerland
7
Institute of Internal Medicine and Nephrology, Clinic Hirslanden Zurich, 8032 Zurich, Switzerland
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2021, 10(15), 3200; https://doi.org/10.3390/jcm10153200
Submission received: 25 June 2021 / Revised: 11 July 2021 / Accepted: 19 July 2021 / Published: 21 July 2021
(This article belongs to the Section Pharmacology)
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Abstract

There is a growing number of evidence-based indications for pharmacogenetic (PGx) testing. We aimed to evaluate clinical relevance of a 16-gene panel test for PGx-guided pharmacotherapy. In an observational cohort study, we included subjects tested with a PGx panel for variants of ABCB1, COMT, CYP1A2, CYP2B6, CYP3A4, CYP3A5, CYP2C9, CYP2C19, CYP2D6, CYP4F2, DPYD, OPRM1, POR, SLCO1B1, TPMT and VKORC1. PGx-guided pharmacotherapy management was supported by the PGx expert system SONOGEN XP. The primary study outcome was PGx-based changes and recommendations regarding current and potential future medication. PGx-testing was triggered by specific drug–gene pairs in 102 subjects, and by screening in 33. Based on PharmGKB expert guidelines we identified at least one “actionable” variant in all 135 (100%) tested patients. Drugs that triggered PGx-testing were clopidogrel in 60, tamoxifen in 15, polypsychopharmacotherapy in 9, opioids in 7, and other in 11 patients. Among those, PGx variants resulted in clinical recommendations to change PGx-triggering drugs in 33 (32.4%), and other current pharmacotherapy in 23 (22.5%). Additional costs of panel vs. single gene tests are moderate, and the efficiency of PGx panel testing challenges traditional cost-benefit calculations for single drug–gene pairs. However, PGx-guided pharmacotherapy requires specialized expert consultations with interdisciplinary collaborations.
Keywords: pharmacotherapy; pharmacogenetics; genetic panel tests; clinical relevance; CYP450; SONOGEN XP pharmacotherapy; pharmacogenetics; genetic panel tests; clinical relevance; CYP450; SONOGEN XP

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MDPI and ACS Style

Niedrig, D.F.; Rahmany, A.; Heib, K.; Hatz, K.-D.; Ludin, K.; Burden, A.M.; Béchir, M.; Serra, A.; Russmann, S. Clinical Relevance of a 16-Gene Pharmacogenetic Panel Test for Medication Management in a Cohort of 135 Patients. J. Clin. Med. 2021, 10, 3200. https://doi.org/10.3390/jcm10153200

AMA Style

Niedrig DF, Rahmany A, Heib K, Hatz K-D, Ludin K, Burden AM, Béchir M, Serra A, Russmann S. Clinical Relevance of a 16-Gene Pharmacogenetic Panel Test for Medication Management in a Cohort of 135 Patients. Journal of Clinical Medicine. 2021; 10(15):3200. https://doi.org/10.3390/jcm10153200

Chicago/Turabian Style

Niedrig, David F., Ali Rahmany, Kai Heib, Karl-Dietrich Hatz, Katja Ludin, Andrea M. Burden, Markus Béchir, Andreas Serra, and Stefan Russmann. 2021. "Clinical Relevance of a 16-Gene Pharmacogenetic Panel Test for Medication Management in a Cohort of 135 Patients" Journal of Clinical Medicine 10, no. 15: 3200. https://doi.org/10.3390/jcm10153200

APA Style

Niedrig, D. F., Rahmany, A., Heib, K., Hatz, K.-D., Ludin, K., Burden, A. M., Béchir, M., Serra, A., & Russmann, S. (2021). Clinical Relevance of a 16-Gene Pharmacogenetic Panel Test for Medication Management in a Cohort of 135 Patients. Journal of Clinical Medicine, 10(15), 3200. https://doi.org/10.3390/jcm10153200

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