Use of pharmacogenomics in elderly patients treated for cardiovascular diseases

Scientific paper - Review paper

• Author: Nada Božina
• Author: Majda Vrkić Kirhmajer
• Author: Livija Šimičević
• Author: Lana Ganoci
• Author: Nikica Mirošević Skvrce
• Author: Iva Klarica Domjanović
• Author: Iveta Merčep
• Author's institution: University of Zagreb; School of Medicine; (Department of Pharmacology)
• Author's institution: University of Zagreb; School of Medicine; (Department of Internal Medicine)
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Clinical Pharmacology and Toxicology
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract (english)

Older people are increasingly susceptible to adverse drug reactions (ADRs) or therapeutic failure. This could be mediated by considerable polypharmacy, which increases the possibility of drug-drug and drug-gene interactions. Precision medicine, based on individual genetic variations, enables the screening of patients at risk for ADRs and the implementation of personalized treatment regimens. It combines genetic and genomic data with environmental and clinical factors in order to tailor prevention and disease-management strategies, including pharmacotherapy. The identification of genetic factors that influence drug absorption, distribution, metabolism, excretion, and action at the drug target level allows individualized therapy. Positive pharmacogenomic findings have been reported for the majority of cardiovascular drugs (CVD), suggesting that pre-emptive testing can improve efficacy and minimize the toxicity risk. Gene variants related to drug metabolism and transport variability or pharmacodynamics of major CVD have been translated into dosing recommendations. Pharmacogenetics consortia have issued guidelines for oral anticoagulants, antiplatelet agents, statins, and some beta-blockers. Since the majority of pharmacogenetics recommendations are based on the assessment of single drug-gene interactions, it is imperative to develop tools for the prediction of multiple drug-drug-gene interactions, which are common in the elderly with comorbidity. The availability of genomic testing has grown, but its clinical application is still insufficient.

• Keywords (english): Aged; Cardiovascular Agents / adverse effects; Cardiovascular Agents / therapeutic use; Cardiovascular Diseases / drug therapy; Cardiovascular Diseases / genetics; Drug-Related Side Effects and Adverse Reactions / prevention & control; Humans; Pharmacogenetics; Precision Medicine
• Language: english
• Publication type: Scientific paper - Review paper
• Publication status: Published
• Peer review: Peer review
• Publication version: Published version
• Journal title: Croatian Medical Journal
• Numbering: vol. 61, no. 2, pp. 147-158
• p-ISSN: 0353-9504
• e-ISSN: 1332-8166
• DOI: https://doi.org/10.3325/cmj.2020.61.147
• URN:NBN: urn:nbn:hr:105:961915
• Publication: 2020-04-30
• Document URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7230415/
• Type of resource: Text
• Access conditions: Open access
• Created on: 2020-10-27 11:55:13