Translational Software Inc, Bellevue, Wash, has completed a large-scale analysis of the medication lists of 505,000 patients to identify potentially harmful drug-gene interactions. Results of the analysis showed that 20% of patients had a pharmacogenetic profile associated with a severe drug-gene interaction with drugs on their current medication list. An additional 48% of patients had a profile that caused a moderate drug-gene interaction.1

According to the US Centers for Disease Control and Prevention, adverse drug events cause more than one million emergency department visits and 280,000 hospitalizations each year. CDC estimates that $3.5 billion is spent annually on excess medical costs to treat adverse drug events.

For the Translational Software study, a drug-gene interaction was defined as severe when there was a high risk of an adverse drug event or therapeutic failure that might require an alternative therapy or a significant alteration in dosing. A drug-gene interaction was regarded as moderate when there was sufficient risk of an adverse drug event that might require therapy adjustment or close monitoring of the patient.

Pharmacogenetic tests used in the analysis were requested by more than 20,000 physicians representing more than 100 different laboratories. Organizations located in Africa, Asia, and the United States submitted the genotyping data. Over half a million patient samples were reviewed, representing deidentified persons who were patients from 2013 to 2017. The analysis revealed that approximately 375,000 patients (75%) were taking at least one medication for which pharmacogenetic guidance was available.

The medication lists were further analyzed for potential drug-gene interactions with four genes: CYP2C9, CYP2C19, CYP2D6, and SLCO1B1. The most commonly prescribed drugs in the patient population that interacted with these four genes included atorvastatin, clopidogrel, hydrocodone, metoprolol, oxycodone, omeprazole, simvastatin, and tramadol.

Don Rule, Translational Software.

Don Rule, Translational Software.

“These results underscore the fact that patients with specific genetic variations are at increased risk from taking many widely prescribed drugs, such as common pain medications and cardiovascular agents,” says Don Rule, CEO of Translational Software. “There is no question that evidence-based genomic decision support and pharmacogenetic practice guidelines are central to advancing precision medicine initiatives to improve patient outcomes.”

Use of pharmacogenetic testing is valuable for reducing the risk of harmful drug-gene interactions and adverse drug events. Yet the growing volume and complexity of available genetic diagnostic tests make it challenging for physicians to keep current or manually assess all the codeterminants for an appropriate course of treatment.

For more information, visit Translational Software.

REFERENCE

1.  Joshi A, Hachad H, Rule D, et al. Insights from a largescale pharmacogenomics implementation [presentation abstract]. Orlando: University of Florida Precision Medicine Conference, March 8?10 2017.