Perspective

Does cardiology hold pharmacogenetics to an inconsistent standard? A comparison of evidence among recommendations

*Author for correspondence: Tel.: +734 615 4851;

E-mail Address: jluzum@med.umich.edu

Department of Clinical Pharmacy, University of Michigan College of Pharmacy, Ann Arbor, MI, USA

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Jason C Cheung

Department of Clinical Pharmacy, University of Michigan College of Pharmacy, Ann Arbor, MI, USA

Department of Pharmacy, Baptist Health Floyd, New Albany, IN, USA

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Published Online:10 Sep 2018https://doi.org/10.2217/pgs-2018-0097

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Abstract

Current guideline recommendations for pharmacogenetic testing for clopidogrel by the American Heart Association/American College of Cardiology (AHA/ACC) contradict the Clinical Pharmacogenetics Implementation Consortium and the US FDA. The AHA/ACC recommends against routine pharmacogenetic testing for clopidogrel because no randomized controlled trials have demonstrated that testing improves patients’ outcomes. However the AHA/ACC and the National Comprehensive Cancer Network (NCCN) recommend other pharmacogenetic tests in the absence of randomized controlled trials evidence. Using clopidogrel as a case example, we compared the evidence for other pharmacogenetic tests recommended by the AHA/ACC and NCCN. In patients that received percutaneous coronary intervention, the evidence supporting pharmacogenetic testing for clopidogrel is stronger than other pharmacogenetic tests recommended by the AHA/ACC and NCCN.

Keywords:

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Vol. 19, No. 15

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History

Received 11 June 2018

Accepted 17 August 2018

Published online 10 September 2018

Published in print October 2018

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Financial & competing interests disclosure

JA Luzum was supported by the NIH Loan Repayment Program through the National Heart, Lung, and Blood Institute (L30 HL110279-02) and a New Investigator Award from the American Association of Colleges of Pharmacy. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

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