Nine-gene pharmacogenomics profile service: The Mayo Clinic experience

Eric T. Matey, Ashley Kate Ragan, Lance J. Oyen, Carolyn R. Vitek, Stacy L. Aoudia, Ahmed K. Ragab, Kelliann C. Fee-Schroeder, John L. Black, Ann M. Moyer, Wayne T Nicholson, Sofia Shrestha, Tammy M. McAllister, Jason P. Sinnwell, Stephanie Faubion, Konstantinos N. Lazaridis

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose: The Pharmacogenomics (PGx) Profile Service was a proof-of-concept project to implement PGx in patient care at Mayo Clinic. Methods: Eighty-two healthy individuals aged 18 and older underwent genotyping of CYP1A2, CYP2C9, CYP2C19, CYP2D6, CYP3A4, CYP3A5, SLCO1B1, HLA-B*58:01, and VKORC1. A PGx pharmacist was involved in ordering, meeting with patients, interpreting, reviewing, and documenting results. Results: Ninety three percent were CYP1A2 rapid metabolizers, 92% CYP3A4 normal metabolizers, and 88% CYP3A5 poor metabolizers; phenotype frequencies for CYP2C19 and CYP2D6 varied. Seventy-three percent had normal functioning SLCO1B1 transporter, 4% carried the HLA-B*58:01 risk variant, and 35% carried VKORC1 and CYP2C9 variants that increased warfarin sensitivity. Conclusion: Pre-emptive PGx testing offered medication improvement opportunity in 56% of participants for commonly used medications. A collaborative approach involving a PGx pharmacist integrated within a clinical practice with regards to utility of PGx results allowed for implementation of the PGx Profile Service. Key points: The Mayo Clinic PGx (PGx) Profile Service was a proof-of-concept project to utilize PGx testing as another clinical tool to enhance medication selection and decrease serious adverse reactions or medication failures.Over one-half of participants in the pilot using the PGx Profile Service were predicted to benefit from pre-emptive PGx testing to guide pharmacotherapy.PGx pharmacists played a crucial role in the PGx Profile Service by educating participants, identifying medication-gene interactions, and providing evidence-based (CPIC and DPWG) PGx recommendations for past, current, and future medication us.

Original languageEnglish (US)
JournalPharmacogenomics Journal
DOIs
StateAccepted/In press - 2021

ASJC Scopus subject areas

  • Molecular Medicine
  • Genetics
  • Pharmacology

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