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Implementation of Integrated Clinical Pharmacogenomics Testing at an Academic Medical Center.
J Appl Lab Med
December 2024
Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, United States.
Background: Pharmacogenomics has demonstrated benefits for clinical care, including a reduction in adverse events and cost savings. However, barriers in expanded implementation of pharmacogenomics testing include prolonged turnaround times and integration of results into the electronic health record with clinical decision support. A clinical workflow was developed and implemented to facilitate in-house result generation and incorporation into the electronic health record at a large academic medical center.
View Article and Find Full Text PDFClinical implementation of preemptive pharmacogenomics testing for personalized medicine at an academic medical center.
J Am Med Inform Assoc
December 2024
University of California, San Francisco, San Francisco, CA 94143, United States.
Objective: This article describes the implementation of preemptive clinical pharmacogenomics (PGx) testing linked to an automated clinical decision support (CDS) system delivering actionable PGx information to clinicians at the point of care at UCSF Health, a large Academic Medical Center.
Methods: A multidisciplinary team developed the strategic vision for the PGx program. Drug-gene interactions of interest were compiled, and actionable alleles identified.
Implementation of pharmacogenomics: Experience at Ochsner Health.
Am J Health Syst Pharm
October 2024
Specialty and Infusion Pharmacies, University of Illinois Health, Chicago, IL, and Department of Pharmacy Practice, University of Illinois Chicago, Chicago, IL, USA.
Purpose: Pharmacogenomics is the study of how individual responses to medication are influenced by genetics. As medication experts, pharmacists are uniquely suited to practicing this application of precision medicine. Fundamental operational aspects of developing a pharmacy clinical pharmacogenomics practice are described, and the specific experience of a multisite health system in developing a pharmacogenomics service is discussed.
View Article and Find Full Text PDFThe variation landscape of CYP2D6 in a multi-ethnic Asian population.
Sci Rep
July 2024
Nalagenetics Pte Ltd, Singapore, Singapore.
Cytochrome P450 2D6 (CYP2D6) plays a crucial role in metabolizing approximately 20% of medications prescribed clinically. This enzyme is encoded by the CYP2D6 gene, known for its extensive polymorphism with over 170 catalogued haplotypes or star alleles, which can have a profound impact on drug efficacy and safety. Despite its importance, a gap exists in the global genomic databases, which are predominantly representative of European ancestries, thereby limiting comprehensive knowledge of CYP2D6 variation in ethnically diverse populations.
View Article and Find Full Text PDFTime-course cross-species transcriptomics reveals conserved hepatotoxicity pathways induced by repeated administration of cyclosporine A.
Toxicol Mech Methods
November 2024
Department of Pharmacology and PharmacoGenomics Research Center, Inje University College of Medicine, Busan, Republic of Korea.
Article Synopsis
- Cyclosporine A (CsA) is effective for immunity-related diseases but can be toxic to the liver, prompting research into its hepatotoxicity mechanisms.
- This study used various data from humans, mice, and rats to analyze changes in gene expression and identify pathways affected by CsA over time, focusing on liver microtissues and tissues from different species.
- Results highlighted specific up-regulated and down-regulated genes and pathways, indicating consistent biological changes across species, which aids in understanding CsA toxicity and advancing biomarker discovery.
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