Volume 11 Issue 4
Jul.  2020
Turn off MathJax
Article Contents
Fei WANG, Zhi-hui WU, Hao-wei MIN, Le YU, Zhao-yun JIANG, Chong ZHU, Meng-chun GONG, Wen-zhao SHI, Wei-guo ZHU, Yan-zhen XIANG. Clinical Deployment Strategies and Processes for Pharmacogenomics[J]. Medical Journal of Peking Union Medical College Hospital, 2020, 11(4): 443-448. doi: 10.3969/j.issn.1674-9081.2020.04.015
Citation: Fei WANG, Zhi-hui WU, Hao-wei MIN, Le YU, Zhao-yun JIANG, Chong ZHU, Meng-chun GONG, Wen-zhao SHI, Wei-guo ZHU, Yan-zhen XIANG. Clinical Deployment Strategies and Processes for Pharmacogenomics[J]. Medical Journal of Peking Union Medical College Hospital, 2020, 11(4): 443-448. doi: 10.3969/j.issn.1674-9081.2020.04.015

Clinical Deployment Strategies and Processes for Pharmacogenomics

doi: 10.3969/j.issn.1674-9081.2020.04.015
More Information
  • Corresponding author: ZHU Wei-guo  Tel:86-10-69154149, E-mail:zhuwg@pumch.cn; XIANG Yan-zhen  Tel:86-10-69155806, E-mail:xiangyz@pumch.cn
  • Received Date: 2018-06-19
  • Publish Date: 2020-07-30
  • With the rapid development of sequencing technology, a large number of clinical cases with personalized medicine have been accumulated. Abundant evidence-based medical data have promoted the rapid development of pharmacogenomics. However, it could play an important role only if it would be deployed in clinical practice. There are two strategies for the clinical deployment of pharmacogenomics:reactive strategy and preemptive strategy. Different deployment strategies require different deployment processes. The specific implementation process involves the integration of EMR, selection of gene-drug pairs, cost-effectiveness, education and training, etc. This paper reviewed the strategies and implementation workflow of pharmacogenomics clinical deployment, and discussed the challenges so as to provide guidance for the clinicaldeployment of pharmacogenomics in China.
  • loading
  • [1] 中华人民共和国国家卫生和计划生育委员会.药物代谢酶和药物作用靶点基因检测技术指南(试行)[S].国卫医医护便函[2015]第240号.
    [2] 中华人民共和国国家卫生和计划生育委员会.肿瘤个体化治疗检测技术指南(试行)[S].国卫医医护便函[2015]第240号.
    [3] Dunnenberger HM, Crews KR, Hoffman JM, et al. Preemptive clinical pharmacogenetics implementation:current programs in five US medical centers[J]. Annu Rev Pharmacol Toxicol, 2015, 55:89-106. doi:  10.1146/annurev-pharmtox-010814-124835
    [4] Carpenter JS, Rosenman MB, Knisely MR, et al. Pharmacogenomically actionable medications in a safety net health care system[J]. SAGE Open Med, 2016, 4:2050312115624333. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=Doaj000004720487
    [5] Jaja C, Bowman L, Wells L, et al. Preemptive Genotyping of CYP2C8 and CYP2C9 Allelic Variants Involved in NSAIDs Metabolism for Sickle Cell Disease Pain Management[J]. Clin Transl Sci, 2015, 8:272-280. doi:  10.1111/cts.12260
    [6] Saldivar JS, Taylor D, Sugarman EA, et al. Initial assessment of the benefits of implementing pharmacogenetics into the medical management of patients in a long-term care facility[J]. Pharmgenomics Pers Med, 2016, 9:1-6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4725634/
    [7] Finkelstein J, Friedman C, Hripcsak G, et al. Potential utility of precision medicine for older adults with polypharmacy:a case series study[J]. Pharmgenomics Pers Med, 2016, 9:31-45.
    [8] Schildcrout JS, Denny JC, Bowton E, et al. Optimizing Drug Outcomes Through Pharmacogenetics:A Case for Preemptive Genotyping[J]. Clin Pharmacol Ther, 2012, 92:235-242. doi:  10.1038/clpt.2012.66
    [9] Plumpton CO, Roberts D, Pirmohamed M, et al. A Systematic Review of Economic Evaluations of Pharmacogenetic Testing for Prevention of Adverse Drug Reactions[J]. Pharmacoeconomics, 2016, 34:771-793. doi:  10.1007/s40273-016-0397-9
    [10] Van Driest SL, Shi Y, Bowton EA, et al. Clinically actionable genotypes among 10, 000 patients with preemptive pharmacogenomic testing[J]. Clin Pharmacol Ther, 2014, 95:423-431. doi:  10.1038/clpt.2013.229
    [11] 阳国平, 郭成贤.药物基因组学与个体化治疗用药决策[M].北京:人民卫生出版社, 2016.
    [12] Shuldiner AR, Relling MV, Peterson JF, et al. The Pharmacogenomics Research Network Translational Pharmacogenetics Program:overcoming challenges of real-world implementation[J]. Clin Pharmacol Ther, 2013, 94:207-210. doi:  10.1038/clpt.2013.59
    [13] 孙可欣, 詹思延, 胡永华.医学大数据在药物基因组学领域中的应用与发展[J].药物流行病学杂志, 2017, 26:68-73. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=ywlxbxzz201701018
    [14] Rasmussentorvik LJ, Stallings SC, Gordon AS, et al. Design and Anticipated Outcomes of the eMERGE-PGx Project:A Multicenter Pilot for Preemptive Pharmacogenomics in Electronic Health Record Systems[J]. Clin Pharmacol Ther, 2014, 96:482-489. doi:  10.1038/clpt.2014.137
    [15] Demmer LA, Waggoner DJ. Professional Medical Education and Genomics[J]. Annu Rev Genomics Hum Genet, 2014, 15:507-516. doi:  10.1146/annurev-genom-090413-025522
    [16] Nickola TJ, Green JS, Harralson AF, et al. The current and future state of pharmacogenomics medical education in the USA[J]. Pharmacogenomics, 2012, 13:1419-1425. doi:  10.2217/pgs.12.113
    [17] 许景峰.药物基因组学应用于临床药学是个体化用药的必然趋势[J].药学服务与研究, 2009, 9:161-165. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=yxfwyyj200903001
    [18] Verbelen M, Weale ME, Lewis CM. Cost-effectiveness of pharmacogenetic-guided treatment:are we there yet?[J]. Pharmacogenomics J, 2017, 17:395-402. doi:  10.1038/tpj.2017.21
    [19] 谭重庆, 彭六保, 曾小慧, 等.药物基因组学领域药物经济学评价的问题探讨[J].中国医院药学杂志, 2016, 36:1339-1342. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=zgyyyx201616001
    [20] Tavadia SM, Mydlarski PR, Reis MD, et al. Screening for azathioprine toxicity:A pharmacoeconomic analysis based on a target case[J]. J Am Acad Dermatol, 2000, 42:628-632. doi:  10.1067/mjd.2000.103980
    [21] Desta Z, Zhao X, Shin JG, et al. Clinical significance of the cytochrome P4502C19 genetic polymorphism[J]. Clin Pharmacokinet, 2002, 41:913-958. doi:  10.2165/00003088-200241120-00002
    [22] Chou WH, Yan FX, De LJ, et al. Extension of a pilot study:impact from the cytochrome P4502D6 polymorphism on outcome and costs associated with severe mental illness[J]. J Clin Psychopharmacol, 2000, 20:246-251. doi:  10.1097/00004714-200004000-00019
    [23] Priest VL, Begg EJ, Gardiner SJ, et al. Pharmacoeconomic Analyses of Azathioprine, Methotrexate and Prospective Pharmacogenetic Testing for the Management of Inflammatory Bowel Disease[J]. Pharmacoeconomics, 2006, 24:767-781. doi:  10.2165/00019053-200624080-00004
    [24] Perlis RH, Ganz DA, Avorn J, et al. Pharmacogenetic testing in the clinical management of schizophrenia:a decision-analytic model[J]. J Clin Psychopharmacol, 2005, 25:427-434. doi:  10.1097/01.jcp.0000177553.59455.24
    [25] Meckley LM, Veenstra DL. Screening for the alpha-adducin Gly460Trp variant in hypertensive patients:a cost-effectiveness analysis[J]. Pharmacogenet Genomics, 2006, 16:139-147. doi:  10.1097/01.fpc.0000189801.96220.82
    [26] Winter J, Walker A, Shapiro D, et al. Cost-effectiveness of thiopurine methyltransferase genotype screening in patients about to commence azathioprine therapy for treatment of inflammatory bowel disease[J]. Aliment Pharmacol Ther, 2004, 20:593-599. doi:  10.1111/j.1365-2036.2004.02124.x
    [27] Me VDAM, Gurwitz D, Detmar SB, et al. Cost-effectiveness of pharmacogenomics in clinical practice:a case study of thiopurine methyltransferase genotyping in acute lymphoblastic leukemia in Europe[J]. Pharmacogenomics, 2006, 7:783-792. doi:  10.2217/14622416.7.5.783
    [28] Maitland-van der Zee AH, Klungel OH, Stricker BH, et al. Pharmacoeconomic evaluation of testing for angiotensin-converting enzyme genotype before starting beta-hydroxy-beta-methylglutaryl coenzyme A reductase inhibitor therapy in men[J]. Pharmacogenetics, 2004, 14:53-60. doi:  10.1097/00008571-200401000-00006
    [29] Weiskopf NG, Weng C. Methods and dimensions of electronic health record data quality assessment:enabling reuse for clinical research[J]. J Am Med Inform Assoc, 2013, 20:144-151. doi:  10.1136/amiajnl-2011-000681
    [30] Zhang J, Johnson TR, Patel VL, et al. Using usability heuristics to evaluate patient safety of medical devices[J]. J Biomed Inform, 2003, 36:23-30. doi:  10.1016/S1532-0464(03)00060-1
    [31] 柴怡, 赵俊, 孙宁生, 等.医学伦理审查规范流程的探讨[C].中华医学会第12次全国医学科学研究管理学学术年会, 2010, 153-156.
    [32] 王维嘉.医学伦理委员会规范运行中应注意的几个问题[C].中华医学会医学伦理学分会学术年会, 2007, 284-286.
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Article Metrics

    Article views (631) PDF downloads(234) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return