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Resultados del ensayo ACCOuNT: un ensayo prospectivo de implementación farmacogenómica multiinstitucional para

Zhong Huang¹, Kevin J O'Leary², Edith A Nutescu³

¹Pritzker School of Medicine, The University of Chicago, Chicago, Illinois, USA.

Clinical pharmacology and therapeutics

|August 23, 2025

Resumen

El apoyo a la decisión clínica farmacogenómica (PGx CDS) en pacientes afroamericanos internados mostró un impacto modesto en la reducción de la prescripción discordante. Sin embargo, los equipos de atención con frecuencia usaban PGx CDS para afirmar las opciones de medicamentos genómicamente concordantes.

Área de la Ciencia:

Farmacología clínica
La genómica
Equidad en salud

Sus antecedentes:

La aplicación de la farmacogenómica está creciendo, sin embargo, faltan ensayos prospectivos en poblaciones subrepresentadas.
El objetivo del ensayo ACCOuNT fue evaluar la utilidad farmacogenómica en pacientes afroamericanos internados.

Objetivo del estudio:

Evaluar el impacto de un sistema de apoyo a la decisión clínica farmacogenómica (PGx CDS) en la prescripción genómicamente concordante en pacientes hospitalizados afroamericanos.
Evaluar la utilidad de la información farmacogenómica para orientar la prescripción en pacientes hospitalizados.

Principales métodos:

Un estudio prospectivo multiinstitucional que incluye genotipos de pacientes afroamericanos internados.
Los resultados farmacogenómicos se integraron en un sistema PGx CDS escalable.
Se evaluó la concordancia de prescripción y la utilización de PGx CDS en 518 admisiones.

Principales resultados:

PGx CDS se utilizó en el 50% de las admisiones; el 12% de las recetas tenían anotaciones farmacogenómicas.
El uso de PGx CDS no disminuyó significativamente las prescripciones discordantes genómicamente (3,9% frente a 3,3%).
Los equipos de atención utilizaron con frecuencia PGx CDS para afirmar recetas genómicamente concordantes (48% de las admisiones).

Conclusiones:

La relevancia de la farmacogenómica procesable actual para la prescripción hospitalaria en poblaciones subrepresentadas es modesta.
Se observó un uso frecuente de PGx CDS para afirmar la prescripción concordante, lo que sugiere un papel en el refuerzo de las opciones de medicamentos apropiados.
Este ensayo proporciona los primeros datos prospectivos de farmacogenómica en pacientes afroamericanos internados, destacando áreas para futuras investigaciones.

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