Clinically Actionable Genotypes Among 10,000 Patients With Preemptive Pharmacogenomic Testing

Since September 2010, more than 10,000 patients have undergone preemptive, panel‐based pharmacogenomic testing through the Vanderbilt Pharmacogenomic Resource for Enhanced Decisions in Care and Treatment program. Analysis of the genetic data from the first 9,589 individuals reveals that the frequenc...

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Bibliographic Details
Published in:Clinical pharmacology and therapeutics 2014-04, Vol.95 (4), p.423-431
Main Authors: Van Driest, SL, Shi, Y, Bowton, EA, Schildcrout, JS, Peterson, JF, Pulley, J, Denny, JC, Roden, DM
Format: Article
Language:English
Subjects:
African Americans - genetics
Aged
Biological and medical sciences
Female
Gene Frequency
Genetic Testing - methods
Genetic Variation
Genotype
Humans
Male
Medical sciences
Middle Aged
Pharmacogenetics
Pharmacology. Drug treatments
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Summary:Since September 2010, more than 10,000 patients have undergone preemptive, panel‐based pharmacogenomic testing through the Vanderbilt Pharmacogenomic Resource for Enhanced Decisions in Care and Treatment program. Analysis of the genetic data from the first 9,589 individuals reveals that the frequency of genetic variants is concordant with published allele frequencies. Based on five currently implemented drug–gene interactions, the multiplexed test identified one or more actionable variants in 91% of the genotyped patients and in 96% of African American patients. Using medication exposure data from electronic medical records, we compared a theoretical “reactive,” prescription‐triggered, serial single‐gene testing strategy with our preemptive, multiplexed genotyping approach. Reactive genotyping would have generated 14,656 genetic tests. These data highlight three advantages of preemptive genotyping: (i) the vast majority of patients carry at least one pharmacogenetic variant; (ii) data are available at the point of care; and (iii) there is a substantial reduction in testing burden compared with a reactive strategy. Clinical Pharmacology & Therapeutics (2014); 95 4, 423–431. doi:10.1038/clpt.2013.229
ISSN:0009-9236
1532-6535
DOI:10.1038/clpt.2013.229