Use of pharmacogenomics in elderly patients treated for cardiovascular diseases

Znanstveni rad - Pregledni rad

• Autor: Nada Božina
• Autor: Majda Vrkić Kirhmajer
• Autor: Livija Šimičević
• Autor: Lana Ganoci
• Autor: Nikica Mirošević Skvrce
• Autor: Iva Klarica Domjanović
• Autor: Iveta Merčep
• Autorova ustanova: Sveučilište u Zagrebu; Medicinski fakultet; (KATEDRA ZA TEMELJNU I KLINIČKU FARMAKOLOGIJU)
• Autorova ustanova: Sveučilište u Zagrebu; Medicinski fakultet; (KATEDRA ZA INTERNU MEDICINU)
• Znanstveno / umjetničko područje, polje i grana: BIOMEDICINA I ZDRAVSTVO; Kliničke medicinske znanosti; Klinička farmakologija s toksikologijom
• Znanstveno / umjetničko područje, polje i grana: BIOMEDICINA I ZDRAVSTVO; Kliničke medicinske znanosti; Interna medicina

Sažetak (engleski)

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.

• Ključne riječi (engleski): 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
• Jezik: engleski
• Vrsta publikacije: Znanstveni rad - Pregledni rad
• Status objave: Objavljen
• Vrsta recenzije: Recenziran
• Verzija publikacije: Objavljena verzija rada (izdavačev PDF)
• Naslov časopisa: Croatian Medical Journal
• Brojčani podaci: vol. 61, br. 2, str. 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
• Datum objave publikacije: 2020-04-30
• URL dokumenta: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7230415/
• Vrsta resursa: Tekst
• Prava pristupa: Otvoreni pristup
• Datum i vrijeme pohrane: 2020-10-27 11:55:13