药物遗传学和不良药物报告:来自英国国家药监数据库的见解
Emma F Magavern1, Maia Megase1, Jack Thompson2
1William Harvey Research Institute, Queen Mary University of London, London, United Kingdom.
PLoS medicine
|March 27, 2025
概括
9%的药物不良反应 (ADR) 与遗传因素有关,其中三个关键的药物基因可能会减轻大多数风险. 精神病学显示,通过药物基因组实施来减少ADR的最大潜力.
科学领域:
- 药物基因组学 药物基因组学
- 药品安全 药品安全
- 监管科学 监管科学
背景情况:
- 药物不良反应 (ADR) 对患者和医疗保健系统构成重大风险.
- 遗传变异影响个体对药物的反应,影响ADR风险.
- 了解与药物基因组 (PGx) 药物对相关的ADRs的人口水平范围对于降低风险至关重要.
研究的目的:
- 在国家药监数据集中描述药物基因与药物相关的ADR报告的情况.
- 为了确定通过药物基因组学 (PGx) 实现可实现的ADR缓解的潜在规模.
主要方法:
- 来自英国MHRA的所有公开可用的黄卡ADR报告 (1963-2024) 的分析.
- 对ADR进行描述性统计分析,按PGx状态和相关基因分层.
- 对PGx相关药物的处方患病率与年龄相匹配的ADR报告进行比较.
主要成果:
- 在1345,712份ADR报告中,有9%与PGx指南 (115,789份报告) 可以采取行动的药物有关.
- 75%的PGx可减轻的不良反应涉及与三个关键药物基因相互作用的药物:CYP2C19,CYP2D6和SLCO1B1.
- 精神病药物占PGx可减轻ADR的47%,其次是心血管药物 (24%). 经历这些不良反应的患者年龄较大,并有严重的非致命反应.
结论:
- 报告的大量不良反应与遗传倾向有关,这为干预提供了机会.
- 一个由三种药物基因组成的向小组有可能减轻绝大多数PGx可修改的副作用.
- 精神病学是一个具有高影响力的领域,用于试点PGx战略,以减少ADR,发病率,死亡率和医疗保健成本.
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