Genotype-guided antithrombotic therapy
Although current literature indicates both a clinical and a cost-effective benefit of routine genotype-guided treatment of patients treated with clopidogrel, this strategy is not recommended in guidelines. In cardiology, but also in neurology and vascular surgery, the current scientific evidence for this is still insufficient. Nevertheless, the role of pharmacogenetics will gain importance in today's medical world, where the demand for personalised medicine is on the rise. The implementation of genotyping in the clinic will nonetheless be a practical challenge due to a lack of clarity about who will bear the associated costs. In patients with coronary artery disease and a higher bleeding risk, it is valuable to determine the CYP2C19 genotype prior to treatment with clopidogrel. Pending further studies, we recommend that specialists prescribing clopidogrel should determine the CYP2C19 genotype in patients at high risk of recurrent ischemic events.
| Medienart: |
E-Artikel |
|---|
| Erscheinungsjahr: |
2022 |
|---|---|
| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:166 |
|---|---|
| Enthalten in: |
Nederlands tijdschrift voor geneeskunde - 166(2022) vom: 24. Jan. |
| Sprache: |
Niederländisch |
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| Weiterer Titel: |
Genotypegeleide trombocytenaggregatieremming |
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| Beteiligte Personen: |
van den Broek, Wout W A [VerfasserIn] |
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| Themen: |
Cytochrome P-450 CYP2C19 |
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| Anmerkungen: |
Date Completed 03.03.2022 Date Revised 03.03.2022 published: Electronic Citation Status MEDLINE |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM336710275 |
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| 520 | |a Although current literature indicates both a clinical and a cost-effective benefit of routine genotype-guided treatment of patients treated with clopidogrel, this strategy is not recommended in guidelines. In cardiology, but also in neurology and vascular surgery, the current scientific evidence for this is still insufficient. Nevertheless, the role of pharmacogenetics will gain importance in today's medical world, where the demand for personalised medicine is on the rise. The implementation of genotyping in the clinic will nonetheless be a practical challenge due to a lack of clarity about who will bear the associated costs. In patients with coronary artery disease and a higher bleeding risk, it is valuable to determine the CYP2C19 genotype prior to treatment with clopidogrel. Pending further studies, we recommend that specialists prescribing clopidogrel should determine the CYP2C19 genotype in patients at high risk of recurrent ischemic events | ||
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