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Updated: Mar 26, 2026

Determining the Likelihood of Variant Pathogenicity Using Amino Acid-level Signal-to-Noise Analysis of Genetic Variation
Published on: January 16, 2019
Genetic variation among 82 pharmacogenes: The PGRNseq data from the eMERGE network.
W S Bush1, D R Crosslin2, A Owusu-Obeng3
1Case Western Reserve University, Cleveland, Ohio, USA.
Rare genetic variants significantly impact drug response. The eMERGE-PGx study found actionable pharmacogenetic variants in most participants, highlighting challenges for precision medicine implementation.
Area of Science:
- Pharmacogenomics
- Genetics
- Clinical Pharmacology
Background:
- Genetic variations influence drug efficacy and safety.
- The impact of rare genetic variants on drug response is not fully understood.
- The electronic Medical Records and Genomics (eMERGE) Network and Pharmacogenomics Research Network initiated the eMERGE-PGx study.
Purpose of the Study:
- To assess genetic variation in 82 pharmacogenes crucial for precision medicine.
- To analyze the frequency spectrum of genetic variants by type, ancestry, and predicted function.
- To provide sequence-derived data from approximately 5,000 clinical subjects for the February 2015 eMERGE-PGx release.
Main Methods:
- Targeted sequencing of 82 pharmacogenes.
- Analysis of variant frequency, type, ancestry, and predicted function.
- Utilizing data from the eMERGE-PGx study, including approximately 5,000 clinical subjects.
Main Results:
- 95.12% of genes exhibited variants with a Combined Annotation-Dependent Depletion (CADD) score > 20.
- 96.19% of all samples contained at least one Clinical Pharmacogenetics Implementation Consortium (CPIC) Level A actionable variant.
- Detailed variant frequency spectrum categorized by variant type, ancestry, and predicted function was presented.
Conclusions:
- Genetic variation in pharmacogenes is widespread and diverse.
- A high proportion of individuals carry actionable pharmacogenetic variants, presenting opportunities and challenges for clinical implementation.
- Multifaceted research is essential for the successful execution of precision medicine strategies.
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