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Pharmacogenomics Journal最新文献

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An innovative model for pharmacogenomics critical results identification and intervention 药物基因组学的创新模型,关键结果鉴定和干预。
IF 2.9 3区 医学 Q2 GENETICS & HEREDITY Pub Date : 2025-10-02 DOI: 10.1038/s41397-025-00385-y
Ryley Uber, Vanessa A. Hayduk, Alison Flango, Theron Ward, Leeann Webster, Eric A. Wright
Pharmacogenomics (PGx) test results are returned variably across healthcare settings, which can lead to challenges particularly when results require immediate intervention to avoid adverse consequences. While several return of result models exist in literature, a standard-of-care has not been established. We propose a model to safely return PGx results in the context of scaled and sustained PGx testing: an institutional protocol to integrate new PGx results into patient care.
药物基因组学(PGx)测试结果在医疗保健设置中返回变量,这可能导致挑战,特别是当结果需要立即干预以避免不良后果时。虽然文献中存在一些结果回归模型,但尚未建立护理标准。我们提出了一个模型,在规模和持续的PGx测试的背景下安全地返回PGx结果:一个机构协议,将新的PGx结果整合到患者护理中。
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引用次数: 0
Antidepressant drug switching in the Swiss population with a focus on Escitalopram and drugs with pharmacogenetic dosing guidelines: a drug utilization study using claims data 以艾司西酞普兰和药物遗传剂量指南为重点的瑞士人群的抗抑郁药物转换:一项使用索赔数据的药物利用研究。
IF 2.9 3区 医学 Q2 GENETICS & HEREDITY Pub Date : 2025-08-08 DOI: 10.1038/s41397-025-00382-1
M. M. Roth, C. R. Meier, C. A. Huber, H. E. Meyer zu Schwabedissen, S. Allemann, C. Schneider
Depression affects around 10% of the Swiss population. While SSRIs are commonly prescribed, only 30–40% of patients achieve remission. Pharmacogenetic (PGx) factors may explain part of this high rate of SSRI treatment failure. This study examined antidepressant (AD) switching among Swiss patients using escitalopram, focusing on whether they switched to ADs with PGx dosing guidelines (PGx AD) or ADs without PGx dosing guidelines (non-PGx ADs). Data from Swiss health insurance records identified 41 275 patients who used escitalopram between July 2020 and June 2022. While 6.4% (n = 2 638) switched to another antidepressant, only 35.4% of these opted for a PGx AD. Men, younger adults showed higher switching rates, whereas patients on antipsychotic medications switched less. Individuals younger than 20 years old and women were more likely to switch to PGx AD whereas the elderly were less likely to switch to PGx AD.
瑞士约10%的人口患有抑郁症。虽然通常会开ssri类药物,但只有30-40%的患者获得缓解。药物遗传(PGx)因素可以部分解释SSRI治疗失败率高的原因。本研究检查了使用艾司西酞普兰的瑞士患者的抗抑郁药(AD)转换,重点关注他们是否切换到有PGx剂量指南的AD (PGx AD)或没有PGx剂量指南的AD(非PGx ADs)。瑞士健康保险记录的数据显示,在2020年7月至2022年6月期间,有4275名患者使用了艾司西酞普兰。而6.4% (n = 2638)的人转而使用另一种抗抑郁药,其中只有35.4%的人选择了PGx AD。男性,年轻的成年人表现出更高的转换率,而服用抗精神病药物的患者转换率较低。20岁以下的年轻人和女性更有可能转变为PGx AD,而老年人则不太可能转变为PGx AD。
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引用次数: 0
Benchmarking large language models for replication of guideline-based PGx recommendations 对大型语言模型进行基准测试,以复制基于指南的PGx建议。
IF 2.9 3区 医学 Q2 GENETICS & HEREDITY Pub Date : 2025-07-26 DOI: 10.1038/s41397-025-00383-0
Mike Zack, Ioan Slobodchikov, Danil Stupichev, Alex Moore, David Sokolov, Igor Trifonov, Allan Gobbs
We evaluated the ability of large language models (LLMs) to generate clinically accurate pharmacogenomic (PGx) recommendations aligned with CPIC guidelines. Using a benchmark of 599 curated gene–drug–phenotype scenarios, we compared five leading models, including GPT-4o and fine-tuned LLaMA variants, through both standard lexical metrics and a novel semantic evaluation framework (LLM Score) validated by expert review. General-purpose models frequently produced incomplete or unsafe outputs, while our domain-adapted model achieved superior performance, with an LLM Score of 0.92 and significantly faster inference speed. Results highlight the importance of fine-tuning and structured prompting over model scale alone. This work establishes a robust framework for evaluating PGx-specific LLMs and demonstrates the feasibility of safer, AI-driven personalized medicine.
我们评估了大型语言模型(LLMs)生成符合CPIC指南的临床准确药物基因组学(PGx)建议的能力。使用599个精心设计的基因-药物表型场景的基准,我们通过标准的词汇指标和经过专家评审验证的新颖语义评估框架(LLM Score),比较了五种领先的模型,包括gpt - 40和微调的LLaMA变体。通用模型经常产生不完整或不安全的输出,而我们的领域适应模型取得了更好的性能,LLM得分为0.92,推理速度明显加快。结果强调了微调和结构化提示比单独的模型规模的重要性。这项工作为评估pgx特异性llm建立了一个强大的框架,并证明了更安全、人工智能驱动的个性化医疗的可行性。
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引用次数: 0
Impact of low BMI and ABCC2 genotype on the clinical response of sequential anthracycline-taxane chemotherapy receiving breast cancer patients: a hospital-based study 低BMI和ABCC2基因型对序贯蒽环类-紫杉烷化疗乳腺癌患者临床疗效的影响:一项基于医院的研究
IF 2.9 3区 医学 Q2 GENETICS & HEREDITY Pub Date : 2025-07-16 DOI: 10.1038/s41397-025-00380-3
Tanuma Mistry, Sanghamitra Sengupta, R. Suresh Kumar, Nisha Thakur, Partha Nath, Neyaz Alam, Vilas D. Nasare
This study investigates combine effect of low BMI and possible pharmacogenetic influence of ABC gene polymorphisms in treatment responses of BC patients. BMI was analysed prior to commencement of chemotherapy. Clinical response was evaluated by radiological imaging and categorised as per RECISTv.1 criteria. SNPs (C1236T, C3435T, C58626A) in ABCB1 and ABCC2 gene were selected. 148 patients were analysed using PCR-RFLP. ABCC2 (58626AA) was significantly associated with treatment non-responsiveness in all genetic models namely dominant (OR 2.954; [1.442–6.051]; p = 0.003), recessive (OR 5.723; [2.48–13.20]; p < 0.0001), codominant (χ2 21.219; p < 0.0001). The proportion of ORR and NRs were significantly different between low (<18.5) and high (≥18.5) BMI classes (OR 16.097; [7.12–36.35]; p < 0.0001). Furthermore, when treatment response was combined with BMI groups, significant associations were observed for C58626A SNP across all genetic models among low BMI group: dominant (OR 3.324; [1.012–10.406]; p = 0.041), recessive (OR 7.250; [1.533–34.278]; p = 0.012) and codominant (χ2 8.657; p = 0.013). Both PFS (35.31 months; p = 0.005) and OS (39.75 months; p = 0.032) were lowered among AA genotype (ABCC2) while the hazard risk of this genotype was further increased in low BMI patients (HR 1.963). 3435CT genotypes in ABCB1 gene showed 87% reduction in risk of death (HR 0.13; p = 0.025). Low BMI independently and jointly with 58626AA genotype of ABCC2 gene was responsible for poor chemotherapy response and survival outcome among AC-T regimen receiving BC patients. Together, this study underscores the importance of genetic counselling and nutritional assessment for favourable treatment outcomes.
本研究探讨了低BMI和ABC基因多态性在BC患者治疗反应中可能的药理学影响的综合作用。在化疗开始前分析BMI。临床反应通过放射成像进行评估,并按照RECISTv进行分类。1标准。选择ABCB1和ABCC2基因的snp (C1236T、C3435T、C58626A)。采用PCR-RFLP对148例患者进行分析。在所有遗传模型中,ABCC2 (58626AA)与治疗无反应性显著相关,即显性(OR 2.954;(1.442 - -6.051);p = 0.003),隐性(OR 5.723;(2.48 - -13.20);P 2 21.219;P 2 8.657;p = 0.013)。PFS均为35.31个月;p = 0.005)和OS(39.75个月;p = 0.032)在AA基因型(ABCC2)患者中降低,而在低BMI患者中该基因型的危险风险进一步增加(HR 1.963)。ABCB1基因的3435CT基因型显示死亡风险降低87% (HR 0.13;p = 0.025)。在接受AC-T方案的BC患者中,低BMI单独或联合ABCC2基因58626AA基因型是化疗反应差和生存结局差的原因。总之,这项研究强调了遗传咨询和营养评估对良好治疗结果的重要性。
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引用次数: 0
Correction: Integrating rare genetic variants into DPYD pharmacogenetic testing may help preventing fluoropyrimidine-induced toxicity 更正:将罕见的遗传变异纳入DPYD药理学检测可能有助于预防氟嘧啶引起的毒性。
IF 2.9 3区 医学 Q2 GENETICS & HEREDITY Pub Date : 2025-07-15 DOI: 10.1038/s41397-025-00381-2
Romain Larrue, Sandy Fellah, Benjamin Hennart, Naoual Sabaouni, Nihad Boukrout, Cynthia Van der Hauwaert, Clément Delage, Meyling Cheok, Michaël Perrais, Christelle Cauffiez, Delphine Allorge, Nicolas Pottier
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引用次数: 0
Pharmacogenomic-guided opioid therapy for pain: a systematic review and meta-analysis of randomised controlled trials 药物基因组学指导的阿片类药物治疗疼痛:随机对照试验的系统回顾和荟萃分析。
IF 2.9 3区 医学 Q2 GENETICS & HEREDITY Pub Date : 2025-07-12 DOI: 10.1038/s41397-025-00379-w
S. Jethwa, M. Ball, K. Langlands
Optimising opioid therapy is challenging due to variable patient responses linked to genetic variation. Pharmacogenomic-guided prescribing holds promise for personalisation, but its clinical effectiveness requires evaluation. We performed a systematic review and meta-analysis of RCTs comparing pharmacogenomic-guided versus standard opioid prescribing in adults. Adhering to PRISMA, we assessed risk of bias (RoB 2) and evidence certainty (GRADE). Six RCTs met inclusion criteria from 2496 screened articles. Meta-analysis showed pharmacogenomic-guided prescribing was associated with significantly reduced opioid consumption (SMD −0.38, 95% CI −0.67 to −0.08, p = 0.01). However, no significant difference in pain intensity was observed between groups (SMD −0.31, 95% CI −0.89 to 0.27, p = 0.30). Evidence regarding adverse events was limited to one trial, which reported a statistically significant reduction in incidence in the pharmacogenomic group (median [IQR]: 1 [0–2] vs. 3 [1–5]; p < 0.01). Further research is needed to determine if pharmacogenomics can improve opioid therapy outcomes.
由于与遗传变异相关的患者反应不同,优化阿片类药物治疗具有挑战性。药物基因组学指导的处方有望实现个性化,但其临床效果需要评估。我们对对照试验进行了系统回顾和荟萃分析,比较药物基因组学指导与成人标准阿片类药物处方。遵循PRISMA,我们评估了偏倚风险(RoB 2)和证据确定性(GRADE)。从筛选的2496篇文章中,有6篇rct符合纳入标准。荟萃分析显示,药物基因组学指导的处方与阿片类药物消耗显著减少相关(SMD -0.38, 95% CI -0.67至-0.08,p = 0.01)。然而,两组间疼痛强度无显著差异(SMD -0.31, 95% CI -0.89 ~ 0.27, p = 0.30)。关于不良事件的证据仅限于一项试验,该试验报告了药物基因组组发生率的统计学显著降低(中位数[IQR]: 1[0-2]对3 [1-5];p
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引用次数: 0
Utilisation of drugs with pharmacogenetic recommendations in children in Switzerland 瑞士儿童药物遗传学建议用药情况。
IF 2.9 3区 医学 Q2 GENETICS & HEREDITY Pub Date : 2025-07-11 DOI: 10.1038/s41397-025-00378-x
Nina L. Wittwer, Christoph R. Meier, Carola A. Huber, Romy Tilen, Canan Yilmaz, Henriette E. Meyer zu Schwabedissen, Samuel Allemann, Cornelia Schneider
Pharmacogenetics (PGx) is increasingly implemented in the adult population, but its potential in children remains uncertain. The aim of this study was to investigate PGx drug utilization in children in Switzerland, using Helsana claims data between 2017 and 2021. We identified 82 drugs with paediatric guideline annotations associated with variants in 24 genes from the Pharmacogenomics Knowledgebase. Of 159 172 children continuously insured, 66.1% claimed at least one PGx drug during the study period. The three PGx drugs with the highest user numbers were systemically administered ibuprofen (59.1%), ondansetron (8.3%), and locally administered fluorouracil (7.5%). Over 96% of all potential drug-gene interactions were caused by seven genes (CYP2C9, CYP2D6, DPYD, CYP2C19, MT-RNR1, CACNA1S, and RYR1). The high number of children claiming PGx drugs in Switzerland implies that a significant number of children could benefit from PGx testing.
药物遗传学(PGx)越来越多地在成人人群中实施,但其在儿童中的潜力仍不确定。本研究的目的是利用2017年至2021年的Helsana索赔数据,调查瑞士儿童的PGx药物使用情况。我们从药物基因组学知识库中确定了82种具有与24个基因变异相关的儿科指南注释的药物。在159172名持续投保的儿童中,66.1%的儿童在研究期间至少服用了一种PGx药物。使用人数最多的三种PGx药物分别是全身布洛芬(59.1%)、昂丹司琼(8.3%)和局部氟尿嘧啶(7.5%)。超过96%的潜在药物-基因相互作用是由7个基因(CYP2C9、CYP2D6、DPYD、CYP2C19、MT-RNR1、CACNA1S和RYR1)引起的。在瑞士,有大量儿童声称服用了PGx药物,这意味着大量儿童可以从PGx检测中受益。
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引用次数: 0
Analyzing pharmacogenetics cost effectiveness and savings across common health conditions in the United States 分析美国常见健康状况的药物遗传学成本效益和节省。
IF 2.9 3区 医学 Q2 GENETICS & HEREDITY Pub Date : 2025-07-08 DOI: 10.1038/s41397-025-00376-z
Mayuri S. Patel, Emily J. Cicali, Frank A. Orlando
This review describes healthcare cost effectiveness/savings for pharmacogenetics (PGx) and relevant clinical outcomes in selected common health conditions. PGx allows targeted drug treatment based on genotype and phenotype. Studies highlight how PGx testing reduces the morbidity and mortality of adverse drug reactions (ADRs) by predicting unexpected drug metabolism due to genetic variation in cytochrome P450 enzymes (CYPs) and drug-drug interactions caused by altered CYP enzyme phenotype. Despite many available PGx testing platforms and PGx-guided treatments, clinical implementation remains challenging and slow due to limited (1) insurance coverage and reimbursement of testing and pharmacist interpretation, (2) outcome data such as evidence showing the benefits of preemptive PGx testing for efficacy or ADR prevention, and (3) promotion of PGx testing among healthcare professionals. Of these, cost is the most significant barrier to patients and the healthcare system. This review describes how PGx testing can be cost effective or cost saving for payors and the healthcare system, especially for depression, cardiovascular disease, and ADRs.
本综述描述了药物遗传学(PGx)的医疗成本效益/节省以及在选定的常见健康状况下的相关临床结果。PGx允许基于基因型和表型的靶向药物治疗。研究强调PGx检测如何通过预测细胞色素P450酶(CYPs)遗传变异和CYP酶表型改变引起的药物相互作用而降低药物不良反应(adr)的发病率和死亡率。尽管有许多可用的PGx检测平台和PGx指导治疗,但由于有限的(1)保险覆盖范围和检测报销以及药剂师解释,(2)结果数据,如证据显示预防性PGx检测对疗效或预防不良反应的益处,以及(3)PGx检测在医疗保健专业人员中的推广,临床实施仍然具有挑战性和缓慢。其中,成本是患者和医疗保健系统面临的最大障碍。这篇综述描述了PGx检测如何对支付者和医疗保健系统具有成本效益或节省成本,特别是对抑郁症、心血管疾病和不良反应。
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引用次数: 0
STRIPE partners in precision medicine: laboratory perspective 精准医疗领域的STRIPE合作伙伴:实验室视角。
IF 2.9 3区 医学 Q2 GENETICS & HEREDITY Pub Date : 2025-06-30 DOI: 10.1038/s41397-025-00377-y
Ben L. Kong, Benjamin G. Brown, Victoria M. Pratt, Bronwyn Ramey, J. Shawn Jones, Sara L. Rogers
{"title":"STRIPE partners in precision medicine: laboratory perspective","authors":"Ben L. Kong,&nbsp;Benjamin G. Brown,&nbsp;Victoria M. Pratt,&nbsp;Bronwyn Ramey,&nbsp;J. Shawn Jones,&nbsp;Sara L. Rogers","doi":"10.1038/s41397-025-00377-y","DOIUrl":"10.1038/s41397-025-00377-y","url":null,"abstract":"","PeriodicalId":54624,"journal":{"name":"Pharmacogenomics Journal","volume":"25 4","pages":"1-3"},"PeriodicalIF":2.9,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144531141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
CYP2C19 point-of-care testing: where are we now and where should we go? CYP2C19即时检测:我们现在在哪里,我们应该去哪里?
IF 2.9 3区 医学 Q2 GENETICS & HEREDITY Pub Date : 2025-06-13 DOI: 10.1038/s41397-025-00375-0
Leticia A. Shea
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引用次数: 0
期刊
Pharmacogenomics Journal
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