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CYP2C19 and clopidogrel response: more than validation in the real world
1Division of Endocrinology, Diabetes, and Nutrition, Department of Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA. ashuldin@medicine.umaryland.edu
Clinical Pharmacology and Therapeutics
|January 21, 2012
Summary
Electronic health records linked to DNA biobanks show promise for pharmacogenomic research. A study validated EHRs, finding a link between a CYP2C19 gene variant and adverse cardiovascular events in patients taking clopidogrel.
Area of Science:
- Pharmacogenomics
- Clinical Informatics
- Cardiovascular Medicine
Background:
- Electronic health records (EHRs) combined with DNA biobanks offer potential for pharmacogenomic discoveries.
- The utility of these integrated resources for real-world evidence generation remains largely unvalidated.
Purpose of the Study:
- To validate the use of EHRs linked to DNA biobanks for pharmacogenomic research.
- To assess the association between genetic variants and clinical outcomes in a real-world patient population.
Main Methods:
- Utilized electronic health records (EHRs) integrated with DNA biobank data.
- Investigated the impact of the loss-of-function CYP2C19*2 variant on cardiovascular outcomes.
- Compared clopidogrel-treated patients with and without the CYP2C19*2 variant.
Main Results:
- Validated the use of EHRs for pharmacogenomic discovery.
- Demonstrated that the loss-of-function CYP2C19*2 variant was associated with poorer cardiovascular outcomes in patients treated with clopidogrel.
- Observed an effect size comparable to findings from controlled clinical trials.
Conclusions:
- Real-world EHR-DNA biobank data can successfully identify pharmacogenomic associations.
- The findings support the potential of EHR-biobank studies for generating evidence in pharmacogenomics.
- Further research is needed to determine if EHR-biobank studies can replace randomized clinical trials for practice-changing evidence.
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