用现实世界药物使用和基因型数据评估药物遗传检测的价值
Kaisa Litonius1,2,3, Noora Kulla4,5, Petra Falkenbach6
1Department of Clinical Pharmacology, University of Helsinki, Helsinki, Finland.
Clinical pharmacology and therapeutics
|October 4, 2024
概括
由于现实世界的证据有限,药物遗传学测试的实施速度很慢. 将预防性药物遗传小组测试针对最有可能接受可行的药物的患者群体,可能对医疗保健系统具有成本效益.
科学领域:
- 药物基因组学 药物基因组学
- 临床药理学 临床药理学
- 卫生经济学 卫生经济学
背景情况:
- 临床实践中药物遗传测试的采用受到缺乏关于有效实施策略的现实世界的证据的阻碍.
- 需要有针对性的测试方法来优化药物遗传学在患者护理中的使用.
研究的目的:
- 分析大量患者队列中对药物遗传学上可行的药物的处方的现实数据.
- 调查影响这些药物的处方因素.
- 开发用于预防性药物遗传学小组测试的成本效益模型.
主要方法:
- 全国队列 (1425,000名患者) 和大学医院队列 (2,178名患者) 的回顾性分析.
- 检查药物购买和处方的药物遗传学作用药物.
- 针对大学医院患者的一个子集的全基因组基因型化 (n=930).
- 开发一种基于文献的成本效益模型,用于预防性测试.
主要成果:
- 60.4%的患者接受了至少一种药物遗传学上可操作的药物;常见的例子包括布洛芬和可代因.
- 98.8%的基因型患者具有可操作的基因型,23.3%具有可操作的基因药物对.
- 患有肌肉骨或心血管疾病的患者更有可能接受可操作的药物.
- 一个成本效益模型表明,在不包括测试成本的非定向预防性测试中,在2年内,每名患者可节省17.49欧元的潜在成本.
结论:
- 很大一部分患者接受药物遗传学上可操作的药物,大多数患者携带可操作的基因型.
- 针对特定患者群体进行先发制药遗传测试,特别是那些患有高风险疾病的患者,可能是一个合理且潜在的成本效益的策略.
相关概念视频
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00:59Model-Independent Approaches for Pharmacokinetic Data: Noncompartmental Analysis
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01:26Pharmacokinetic Models: Comparison and Selection Criterion
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01:27Nonlinear Pharmacokinetics: Role of Transporters
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