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International Journal of Clinical Pharmacy

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01-02-2011 | Research Article

From evidence based medicine to mechanism based medicine. Reviewing the role of pharmacogenetics

Authors: Bob Wilffert, Jesse Swen, Hans Mulder, Daan Touw, Anke-Hilse Maitland-Van der Zee, Vera Deneer, KNMP working group Pharmacogenetics

Published in: International Journal of Clinical Pharmacy | Issue 1/2011

Abstract

Aim of the review The translation of evidence based medicine to a specific patient presents a considerable challenge. We present by means of the examples nortriptyline, tramadol, clopidogrel, coumarins, abacavir and antipsychotics the discrepancy between available pharmacogenetic information and its implementation in daily clinical practice. Method Literature review. Results A mechanism based approach may be helpful to personalize medicine for the individual patient to which pharmacogenetics may contribute significantly. The lack of consistency in what we accept in bioequivalence and in pharmacogenetics of drug metabolising enzymes is discussed and illustrated with the example of nortriptyline. The impact of pharmacogenetics on examples like tramadol, clopidogrel, coumarins and abacavir is described. Also the present status of the polymorphisms of 5-HT2A and C receptors in antipsychotic-induced weight gain is presented as a pharmacodynamic example with until now a greater distance to clinical implementation. Conclusion The contribution of pharmacogenetics to tailor-made pharmacotherapy, which especially might be of value for patients deviating from the average, has not yet reached the position it seems to deserve.

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Title: From evidence based medicine to mechanism based medicine. Reviewing the role of pharmacogenetics
Authors: Bob Wilffert
Jesse Swen
Hans Mulder
Daan Touw
Anke-Hilse Maitland-Van der Zee
Vera Deneer
KNMP working group Pharmacogenetics
Publication date: 01-02-2011
Publisher: Springer Netherlands
Published in: International Journal of Clinical Pharmacy / Issue 1/2011
Print ISSN: 2210-7703
Electronic ISSN: 2210-7711
DOI: https://doi.org/10.1007/s11096-011-9485-2

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