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2008/9 Catalogue
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Summary
January 2006, Vol. 7, No. 1, Pages 89-103 , DOI 10.2217/14622416.7.1.89
(doi:10.2217/14622416.7.1.89)

Perspective
Challenges and opportunities in the application of pharmacogenetics to antiepileptic drug therapy
Thomas N Ferraro1, Dennis J Dlugos2 & Russell J Buono3
1University of Pennsylvania, Center for Neurobiology and Behavior, Room 2209, Translational Research Laboratories, 125 S.31st St, Philadelphia, PA 19104–3403, USA.
2The Children’s Hospital of Philadelphia, Department of Pediatrics, Philadelphia, PA 19104, USA
3University of Cincinnati, Department of Neurology, Cincinnati, OH 45267, USA
Author for correspondence



The recent surge of interest in pharmacogenetics has provoked considerable thought regarding its relevance to antiepileptic drug (AED) therapy. Initial studies have focused on genes whose products play a putatively important role in AED pharmacology, particularly drug transporter proteins, drug metabolizing enzymes and ion channel subunits. However, there is a lack of good correspondence between results from different laboratories, and more recent findings are awaiting attempts at confirmation. Thus, there are currently no AED treatment guidelines that are informed by pharmacogenetic data. In order to begin to have clinical impact, standards specific to the conduct of future AED studies must be established. Of particular importance are the need for accurate epilepsy classification, appropriate AED selection and clear and objective assessment outcome measures. In addition, general standards for analysis and interpretation of genetic association data must be better codified and applied consistently across studies. Finally, extensive clinical research networks must be formulated and large numbers of well characterized patients must be recruited. Further development of these critical factors will optimize chances for overcoming current challenges posed by AED pharmacogenetic research and ultimately allow the realization of improved, more rational therapeutic strategies.

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Cited by

Wolfgang Löscher, Ulrich Klotz, Fritz Zimprich, Dieter Schmidt. (2009) The clinical impact of pharmacogenetics on the treatment of epilepsy. Epilepsia 50:1, 1-23
Online publication date: 1-Feb-2009.
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Takayuki Seo, Rie Nagata, Takateru Ishitsu, Tsukasa Murata, Chisato Takaishi, Masaharu Hori, Kazuko Nakagawa. (2008) Impact of CYP2C19 polymorphisms on the efficacy of clobazam therapy. Pharmacogenomics 9:5, 527-537
Online publication date: 1-May-2008.
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Ulrich Klotz. (2007) The Role of Pharmacogenetics in the Metabolism of Antiepileptic Drugs. Clinical Pharmacokinetics 46:4, 271
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Takayuki Seo, Takateru Ishitsu, Nao Ueda, Naoyuki Nakada, Keigo Yurube, Kentaro Ueda, Kazuko Nakagawa. (2006) ABCB1 polymorphisms influence the response to antiepileptic drugs in Japanese epilepsy patients. Pharmacogenomics 7:4, 551-561
Online publication date: 1-Jun-2006.
Summary | Full Text | PDF (118 KB) | PDF Plus (185 KB) 
 

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Authors:
Thomas N Ferraro
Dennis J Dlugos
Russell J Buono
Keywords:
antiepileptic drugs
epilepsy
genetic association
pharmacogenetics
treatment outcome assessment