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Putting Gene Tests to Use: More Than a Third of Patients Cannot Properly Metabolize Plavix®
Date:10/13/2011

logists seemed to be more accepting of the use of gene testing."

The analysis also indicated that messages discussing genetic variations and potential drug interactions resulted in 31 percent of doctors making a prescription change shortly after receiving test results.  Preventing drug interactions is as important as testing for genetic variations in drug metabolism in helping doctors ensure the medications they select work most effectively—which can play a role in helping lower healthcare costs.

For example, about 70 percent of patients do not have the CYP2C19 genetic variations that reduce the effectiveness of Plavix, meaning they would be candidates to use a less expensive generic medication when the drug loses patent protection later this year.  However, in order to increase the likelihood that the drug is metabolized effectively, physicians would have to avoid prescribing other medications which inhibit the activity of the CYP2C19 enzyme.

"The combination of drug utilization review and genetic testing gives doctors another tool to make decisions and improve the safety and outcomes for their patients," said Dr. Donald Pittman, the national practice leader for cardiovascular health in the Medco Therapeutic Resource Centers®.  "Genetic testing allows doctors to maximize the cardiovascular benefit and drug and drug utilization review minimizes the risk from drugs that may interfere with the metabolism of Plavix."

Over a third using 2C19 inhibitors

The 100-patient analysis found that 1 percent of the patients could be regarded as "poor metabolizers" (two reduced-function gene components), 29 percent were "intermediate", 37 percent were "extensive" (two normal functioning gene components) and 33 percent were "ultrarapid" metabolizers of CYP2C19.   The research also found that 38 percent of the patients were using drugs that were "2C19 inhibitors"–such as proton pump inhibitors (PPI
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SOURCE Medco Health Solutions, Inc.
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