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An Update on Precision Medicine Advances In Neurodevelopmental Disorders
Dana M Lapato1,2, Ashlee A Moore2,3, Robert Findling3
1Department of Human and Molecular Genetics, Virginia Commonwealth University.
Insights
Precision medicine advances personalized treatments for neurodevelopmental disorders like autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD). Pharmacogenetics, focusing on genes like CYP2D6, guides tailored therapies for better outcomes.
Area of Science:
- Neurodevelopmental Disorders
- Pharmacogenetics
- Precision Medicine
Background:
- Autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) are common neurodevelopmental disorders impacting multiple life domains.
- Current treatments for ASD and ADHD have limitations, highlighting the need for more personalized therapeutic strategies.
- The Precision Medicine Initiative aims to shift from a one-size-fits-all approach to individualized medical care.
Purpose of the Study:
- To review current research on personalized treatment approaches for ASD and ADHD.
- To provide an update on the field of pharmacogenetics and "therapy-genetics" for these conditions.
- To encourage clinical adoption of pharmacogenetic testing aligned with FDA guidelines.
Main Methods:
- Literature review of pharmacogenetic research in ASD and ADHD.
- Focus on key genes involved in drug metabolism, particularly the cytochrome P450 family (e.g., CYP2D6, CYP2C19).
- Analysis of "therapy-genetics" advancements in neurodevelopmental disorder treatment.
Main Results:
- Pharmacogenetic testing primarily targets cytochrome P450 enzymes, crucial for metabolizing many medications.
- Specific gene variants (e.g., CYP2D6, CYP2C19) influence drug efficacy and safety in individuals with ASD and ADHD.
- Emerging "therapy-genetics" approaches offer potential for highly individualized treatment plans.
Conclusions:
- Personalized medicine, driven by pharmacogenetics, holds significant promise for improving ASD and ADHD treatments.
- Clinicians should consider pharmacogenetic testing to optimize medication selection and dosage.
- Adherence to FDA recommendations for pharmacogenetic testing is crucial for advancing patient care.
Abstract:
Neurodevelopmental disorders, including autism spectrum disorder (ASD) and attention-deficit/hyper-activity disorder (ADHD), represent a group of conditions that manifest early in child development and produce impairments across multiple domains of functioning. Although a number of pharmacological and psychosocial treatments exist to improve the symptoms associated with these syndromes, treatment advances have lagged. The Precision Medicine Initiative was launched with the goal of revolutionizing medicine by progressing beyond the historical one-size-fits-all approach. In this review, we evaluate current research efforts to personalize treatments for ASD and ADHD. Most pharmacogenetic testing has focused on the cytochrome P450 enzyme family with a particular focus on CYP2D6 and CYP2C19, which are genes that produce an enzyme that acts as a key metabolizer of many prescribed medications. This article provides an update on the state of the field of pharmacogenetics and "therapy-genetics" in the context of ASD and ADHD, and it also encourages clinicians to follow US Food and Drug Administration recommendations regarding pharmacogenetic testing.
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