Pharmacogenomic Biomarkers and Their Applications in Psychiatry

Kam, Heejin; Jeong, Hotcherl

doi:10.3390/genes11121445

Cited by 22 publications

(13 citation statements)

References 123 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Based on the activity of the enzyme isoforms, patients can range from poor (prone to toxicity), intermediate, extensive/normal, rapid to ultrarapid (prone to reduce efficacy) metabolizers. Thus, poor and intermediate metabolizers are more likely to experience side-effects (e.g., tachycardia) ( Kam and Jeong, 2020 ). For CYP2D6, Caucasians are more likely to carry the wild-type CYP2D6*1 allele and be normal (about 40%) rather than intermediate or poor (< 10%) metabolizers ( Bradford, 2002 ; Ingelman-Sundberg et al, 2007 ).…”

Section: Direct Cardiovascular Effects Of Attention-deficit Hyperacti...mentioning

confidence: 99%

See 1 more Smart Citation

The use of attention-deficit hyperactivity disorder medications in cardiac disease

et al. 2022

View full text Add to dashboard Cite

Attention-deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder with onset usually in childhood characterized by inattention, impulsivity, and hyperactivity causing a functional impairment. Untreated ADHD, or treatment delay is associated with adverse outcomes and poor quality of life. Although conservative management strategies such as behavioral and psychological interventions are important, pharmacological treatment has a strong evidence base with improved outcomes. ADHD medications are broadly divided into stimulant and non-stimulant medications. Stimulant medications are generally more effective than non-stimulants. Cardiovascular safety of ADHD medication has been a matter of debate for decades. Treatment guidelines advise the careful consideration of risks and benefits in people with cardiovascular diseases such as congenital heart disease or cardiomyopathy. Although stimulants can increase systemic blood pressure and heart rate, no significant associations were found between their use and serious cardiovascular events. Concerns regarding QT effects and attendant sudden cardiac death risks deter clinicians from initiating much-needed ADHD medications in patients with heart disease. This overly cautious approach is potentially depriving low-risk individuals from significant benefits associated with timely ADHD drug treatment. This review discusses the cardiovascular risks reportedly associated with ADHD medications, the evidence base for their safe usage in persons with established cardiovascular disease, and highlights future research directions.

show abstract

Section: Direct Cardiovascular Effects Of Attention-deficit Hyperacti...mentioning

confidence: 99%

“…Similarly, there is an ethnicity related polymorphism in CYP3A4 ( Guttman et al, 2019 ). Thus, pharmacogenomic biomarkers are an exciting prospect in the field of precision medicine and personalized pharmacotherapy ( Kam and Jeong, 2020 ).…”

Section: Direct Cardiovascular Effects Of Attention-deficit Hyperacti...mentioning

confidence: 99%

The use of attention-deficit hyperactivity disorder medications in cardiac disease

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Since few CNS drugs have been approved for the past decade, classical PGx studies with psychotropic drugs remain valuable for drug use optimization [11,12,19,27,160]. Pretreatment PGx testing is highly recommended in major neuropsychiatric disorders such as schizophrenia, depression, bipolar disorders, panic disorder, autism spectrum disorder, epilepsy, and neurodegenerative disorders (Alzheimer's disease, Parkinson's disease), which require long-term, toxic treatments [11,12,19,[160][161][162][163][164][165][166][167]. CNS drugs can act as substrates, inhibitors or inducers of enzymes encoded by metabolic genes.…”

Section: Central Nervous System Disordersmentioning

confidence: 99%

Genophenotypic Factors and Pharmacogenomics in Adverse Drug Reactions

Cacabelos

Naidoo

Corzo

et al. 2021

IJMS

View full text Add to dashboard Cite

Adverse drug reactions (ADRs) rank as one of the top 10 leading causes of death and illness in developed countries. ADRs show differential features depending upon genotype, age, sex, race, pathology, drug category, route of administration, and drug–drug interactions. Pharmacogenomics (PGx) provides the physician effective clues for optimizing drug efficacy and safety in major problems of health such as cardiovascular disease and associated disorders, cancer and brain disorders. Important aspects to be considered are also the impact of immunopharmacogenomics in cutaneous ADRs as well as the influence of genomic factors associated with COVID-19 and vaccination strategies. Major limitations for the routine use of PGx procedures for ADRs prevention are the lack of education and training in physicians and pharmacists, poor characterization of drug-related PGx, unspecific biomarkers of drug efficacy and toxicity, cost-effectiveness, administrative problems in health organizations, and insufficient regulation for the generalized use of PGx in the clinical setting. The implementation of PGx requires: (i) education of physicians and all other parties involved in the use and benefits of PGx; (ii) prospective studies to demonstrate the benefits of PGx genotyping; (iii) standardization of PGx procedures and development of clinical guidelines; (iv) NGS and microarrays to cover genes with high PGx potential; and (v) new regulations for PGx-related drug development and PGx drug labelling.

show abstract

“…For example, variation in the CYP2D6 gene influences drug metabolism activity such that individuals who carry deficient CYP2D6 alleles have sub-optimal enzymatic activity and are at higher risk of developing adverse drug reactions. Among psychotropic medications, there are several drug substrates for CYP2D6 , including atomoxetine (attention deficit hyperactivity disorder medication) and clozapine (antipsychotic for treatment of schizophrenia), for which drug labels recommend dose adjustments for patients who are CYP2D6 poor metabolizers [ 40 ]. Studies provide accumulating evidence that PGx testing for CYP enzyme genes can inform drug dosing and selection and improve patient outcomes [ 41 , 42 , 43 , 44 ].…”

Section: Discussionmentioning

confidence: 99%

Pharmacogenomic Biomarkers in US FDA-Approved Drug Labels (2000–2020)

Kim

Ceccarelli

2021

JPM

View full text Add to dashboard Cite

Pharmacogenomics (PGx) is a key subset of precision medicine that relates genomic variation to individual response to pharmacotherapy. We assessed longitudinal trends in US FDA approval of new drugs labeled with PGx information. Drug labels containing PGx information were obtained from Drugs@FDA and guidelines from PharmGKB were used to compare the actionability of PGx information in drug labels across therapeutic areas. The annual proportion of new drug approvals with PGx labeling has increased by nearly threefold from 10.3% (n = 3) in 2000 to 28.2% (n = 11) in 2020. Inclusion of PGx information in drug labels has increased for all clinical areas over the last two decades but most prominently for cancer therapies, which comprise the largest proportion (75.5%) of biomarker–drug pairs for which PGx testing is required. Clinically actionable information was more frequently observed in biomarker–drug pairs associated with cancer drugs compared to those for other therapeutic areas (n = 92 (59.7%) vs. n = 62 (40.3%), p < 0.0051). These results suggest that further evidence is needed to support the clinical adoption of pharmacogenomics in non-cancer therapeutic areas.

show abstract

Pharmacogenomic Biomarkers and Their Applications in Psychiatry

Cited by 22 publications

References 123 publications

The use of attention-deficit hyperactivity disorder medications in cardiac disease

The use of attention-deficit hyperactivity disorder medications in cardiac disease

Genophenotypic Factors and Pharmacogenomics in Adverse Drug Reactions

Pharmacogenomic Biomarkers in US FDA-Approved Drug Labels (2000–2020)

Contact Info

Product

Resources

About