Médecine moléculaire et génétique

An In-Depth Look at the Clinical Relevance of Pharmacogenetic Testing Ascertained

Abstract

Amin Saleh Halum, Muhammad Tahir M Bhinder, Mohammad S Shawaqfeh and Suhaib M Muflih

Background: Pharmacogenetics is the study of genetic influence on pharmacological response. Pharmacogenetic testing serves to identify the presence of genetic variants which may affect pharmacological outcomes, and allows for the selection of pharmacological therapy based on a patient's specific genetic make-up. Therefore, it has the potential to become an invaluable resource in certain fields of medicine to provide patient-tailored pharmacotherapy to patients.
Objective: To determine the clinical relevance of pharmacogenetic testing.
Methods: A systematic review was conducted from September 2013- November 2015 using the EMBASE and EBSCO host databases, identifying English language Cochrane reviews, controlled clinical trials, randomized control trials, meta-analyses and systematic reviews conducted on humans. Search terms pertaining to pharmacogenetic testing in the following medication classes: cardiovascular, oncologic, pain management, antiretroviral, and antidepressant were used. Selected articles were evaluated and assigned ratings based on the level of evidence present. A rating of "A" was assigned for high level of evidence, "B" for moderate level of evidence, and "C" for minimal level of evidence.
Results: The literature search resulted in a total of twenty-one selected articles of interest. Of these articles, seven were identified with an evidence rating of "A" and four articles with an evidence rating of "B".
Conclusion: Pharmacogenetic testing is relevant to clinical practice in certain situations. Its use provides health care providers with additional information which may enable them to treat patients more efficiently by preventing adverse reactions and anticipating therapeutic responses. A lack of prospective randomized control trials, ethical concerns, and a lack of provider knowledge pertaining to pharmacogenetic testing remain as barriers to routine pharmacogenetic testing in clinical practice. Despite these barriers, the future of pharmacogenetic testing is promising and expected to be welcomed by those whom are concerned with providing optimal pharmaceutical care.