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Implementation of clopidogrel pharmacogenetics: a Brazilian perspective
J F Vieira1,2, I H Tassoni1, M L Chaves1,2
1Departamento de Patologia, Genética e Evolução, Instituto de Ciências Biológicas e Naturais, Universidade Federal do Triângulo Mineiro, Uberaba, Brasil.
Pharmacogenomics
|November 6, 2025
Summary
CYP2C19 gene variations affect clopidogrel response, impacting cardiovascular outcomes. Implementing genotype-guided strategies in Brazil requires addressing local challenges for personalized antiplatelet therapy.
Area of Science:
- Pharmacogenomics
- Clinical Pharmacology
- Precision Medicine
Background:
- The CYP2C19 gene is crucial for clopidogrel bioactivation, an antiplatelet drug.
- CYP2C19 genetic variations lead to diverse patient responses and potentially worse cardiovascular outcomes.
- Genotype-guided strategies show promise but face challenges in diverse populations like Brazilians.
Purpose of the Study:
- To discuss the clinical implementation of CYP2C19 genotyping for clopidogrel therapy in Brazil.
- To explore strategies for overcoming barriers to precision medicine in the Brazilian context.
- To propose implementation strategies for CYP2C19-clopidogrel pharmacogenetics at HC-UFTM.
Main Methods:
- Contextual synthesis approach.
- Evidence identification via PubMed (updated July 2025).
- Analysis of structural and scientific barriers to precision medicine implementation.
Main Results:
- CYP2C19 polymorphism significantly influences clopidogrel efficacy and safety.
- International guidelines may not directly apply to Brazil's genetically diverse population.
- Implementation requires addressing national study promotion, infrastructure, training, and public policy.
Conclusions:
- Personalized clopidogrel treatment via CYP2C19 genotyping is beneficial but requires local adaptation.
- Overcoming implementation barriers is essential for successful precision medicine in Brazil.
- A tailored approach is needed for CYP2C19-clopidogrel pharmacogenetics at HC-UFTM and nationally.
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