How to Manage Individualized Drug Therapy: Application of Pharmacogenetic Knowledge of Drug Metabolism and Transport
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Abstract
Significant fractions of health budgets must be spent for treatment of drug side effects and for inefficient drug therapy. Hereditary variants in drug metabolizing enzymes, drug transporters, and drug targets are important determinants of drug response and toxicity and may therefore aid in selection and dosage of drugs. Today there is extensive knowledge of genetic polymorphisms of cytochrome P450 (CYP) enzymes 2A6, 2C9, 2C19, and 2D6; of phase-2 enzymes such as thiopurine S-methyltransferase; and more recently of drug transporters such as the MDR-1 gene-product P-glycoprotein, affecting a significant share of currently used drugs. However, application of pharmacogenetic knowledge to clinical routine is limited in current practice. To promote the application of pharmacogenetic knowledge in clinical routine, research on genotype-based dose adjustments is still necessary—as is the promotion of faster and cheaper genotype analyses. Furthermore, the benefits of CYP genotype-directed drug therapy should be evaluated in properly designed prospective studies. Once such steps have been successfully taken, drug therapy could well become more prevention-directed and patient-tailored than it is possible today, replacing the current “one drug in one dose for one disease” strategy by a more individualized approach.
Copyright © 2000 by Walter de Gruyter GmbH & Co. KG
Articles in the same Issue
- The Basis of the Medicine of Tomorrow "Validating and Using Pharmacogenomics" Joint IFCC-Roche Diagnostics Conference, Kyoto, Japan, 1619 April 2000
- Diagnostics and the Future of Medicine
- Operomics: Molecular Analysis of Tissues from DNA to RNA to Protein
- Idiosyncratic Reactions to Drugs: Can Medicine Response Profiles Provide a Dynamic Drug Surveillance System?
- Hunting for Disease Genes in Multi-Functional Diseases
- Familial Studies on the Genetics of Cardiovascular Diseases: the Stanislas Cohort
- Quantitative PCR
- Gene Amplification as Means for Determining Therapeutic Strategies in Human Cancers
- Apolipoprotein E Polymorphisms and Concentration in Chronic Diseases and Drug Responses
- Angiotensin I-Converting Enzyme Gene Polymorphism and Drug Response
- Drug-Metabolizing Enzymes, Polymorphisms and Interindividual Response to Environmental Toxicants
- Database Analysis and Gene Discovery in Pharmacogenetics
- How to Manage Individualized Drug Therapy: Application of Pharmacogenetic Knowledge of Drug Metabolism and Transport
- P-Glycoprotein and Bioavailability-Implication of Polymorphism
- Cancer Therapy and Polymorphisms of Cytochromes P450
- Polymorphisms in UDP Glucuronosyltransferase Genes: Functional Consequences and Clinical Relevance
- The Human Multidrug Resistance-Associated Protein (MRP) Gene Family: From Biological Function to Drug Molecular Design
- Ethnic Differences in Drug Metabolism
- Hypervariable Region 1 of Hepatitis C Virus Genome and Response to Interferon Therapy
- A Functional Genomic Study of the Effects of Antipsychotic Agent Chlorpromazine in PC12 Cells
- Influence of Glutathione S-Transferase M1 and T1 Genotypes on Larynx Cancer Risk among Korean Smokers
- CYP2D6 Genotyping in Patients on Psychoactive Drug Therapy
- Genotyping of CYP2D6 in Parkinsons's Disease
- Rapid Analysis of CGG Repeat Length in the FMR1 Gene
- Multiplex In-cell Reverse Transcription-Polymerase Chain Reaction for the Simultaneous Detection of p210 and p190 BCR-ABL mRNAs in Chronic Myeloid Leukemia and Philadelphia-Positive Acute Lymphoblastic Leukemia Cell Lines
Articles in the same Issue
- The Basis of the Medicine of Tomorrow "Validating and Using Pharmacogenomics" Joint IFCC-Roche Diagnostics Conference, Kyoto, Japan, 1619 April 2000
- Diagnostics and the Future of Medicine
- Operomics: Molecular Analysis of Tissues from DNA to RNA to Protein
- Idiosyncratic Reactions to Drugs: Can Medicine Response Profiles Provide a Dynamic Drug Surveillance System?
- Hunting for Disease Genes in Multi-Functional Diseases
- Familial Studies on the Genetics of Cardiovascular Diseases: the Stanislas Cohort
- Quantitative PCR
- Gene Amplification as Means for Determining Therapeutic Strategies in Human Cancers
- Apolipoprotein E Polymorphisms and Concentration in Chronic Diseases and Drug Responses
- Angiotensin I-Converting Enzyme Gene Polymorphism and Drug Response
- Drug-Metabolizing Enzymes, Polymorphisms and Interindividual Response to Environmental Toxicants
- Database Analysis and Gene Discovery in Pharmacogenetics
- How to Manage Individualized Drug Therapy: Application of Pharmacogenetic Knowledge of Drug Metabolism and Transport
- P-Glycoprotein and Bioavailability-Implication of Polymorphism
- Cancer Therapy and Polymorphisms of Cytochromes P450
- Polymorphisms in UDP Glucuronosyltransferase Genes: Functional Consequences and Clinical Relevance
- The Human Multidrug Resistance-Associated Protein (MRP) Gene Family: From Biological Function to Drug Molecular Design
- Ethnic Differences in Drug Metabolism
- Hypervariable Region 1 of Hepatitis C Virus Genome and Response to Interferon Therapy
- A Functional Genomic Study of the Effects of Antipsychotic Agent Chlorpromazine in PC12 Cells
- Influence of Glutathione S-Transferase M1 and T1 Genotypes on Larynx Cancer Risk among Korean Smokers
- CYP2D6 Genotyping in Patients on Psychoactive Drug Therapy
- Genotyping of CYP2D6 in Parkinsons's Disease
- Rapid Analysis of CGG Repeat Length in the FMR1 Gene
- Multiplex In-cell Reverse Transcription-Polymerase Chain Reaction for the Simultaneous Detection of p210 and p190 BCR-ABL mRNAs in Chronic Myeloid Leukemia and Philadelphia-Positive Acute Lymphoblastic Leukemia Cell Lines
