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https://www.readbyqxmd.com/read/28815136/design-recommendations-for-pharmacogenomics-clinical-decision-support-systems
#1
Maher Khelifi, Peter Tarczy-Hornoch, Emily B Devine, Wanda Pratt
The use of pharmacogenomics (PGx) in clinical practice still faces challenges to fully adopt genetic information in targeting drug therapy. To incorporate genetics into clinical practice, many support the use of Pharmacogenomics Clinical Decision Support Systems (PGx-CDS) for medication prescriptions. This support was fueled by new guidelines to incorporate genetics for optimizing drug dosage and reducing adverse events. In addition, the complexity of PGx led to exploring CDS outside the paradigm of the basic CDS tools embedded in commercial electronic health records...
2017: AMIA Summits on Translational Science Proceedings
https://www.readbyqxmd.com/read/28705252/efficacy-of-prospective-pharmacogenetic-testing-in-the-treatment-of-major-depressive-disorder-results-of-a-randomized-double-blind-clinical-trial
#2
Víctor Pérez, Ariana Salavert, Jordi Espadaler, Miquel Tuson, Jerónimo Saiz-Ruiz, Cristina Sáez-Navarro, Julio Bobes, Enrique Baca-García, Eduard Vieta, José M Olivares, Roberto Rodriguez-Jimenez, José M Villagrán, Josep Gascón, Josep Cañete-Crespillo, Montse Solé, Pilar A Saiz, Ángela Ibáñez, Javier de Diego-Adeliño, José M Menchón
BACKGROUND: A 12-week, double-blind, parallel, multi-center randomized controlled trial in 316 adult patients with major depressive disorder (MDD) was conducted to evaluate the effectiveness of pharmacogenetic (PGx) testing for drug therapy guidance. METHODS: Patients with a CGI-S ≥ 4 and requiring antidepressant medication de novo or changes in their medication regime were recruited at 18 Spanish public hospitals, genotyped with a commercial PGx panel (Neuropharmagen®), and randomized to PGx-guided treatment (n = 155) or treatment as usual (TAU, control group, n = 161), using a computer-generated random list that locked or unlocked psychiatrist access to the results of the PGx panel depending on group allocation...
July 14, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28698977/pharmacogenetics-and-pharmacogenomics-of-targeted-therapeutics-in-chronic-myeloid-leukemia
#3
REVIEW
Aritro Nath, Jacqueline Wang, R Stephanie Huang
The advent of targeted therapeutics has greatly improved outcomes of chronic myeloid leukemia (CML) patients. Despite increased efficacy and better clinical responses over cytotoxic chemotherapies, many patients receiving targeted drugs exhibit a poor initial response, develop drug resistance, or undergo relapse after initial success. This inter-individual variation in response has heightened the interest in studying pharmacogenetics and pharmacogenomics (PGx) of cancer drugs. In this review, we discuss the influence of various germline and somatic factors on targeted drug response in CML...
July 11, 2017: Molecular Diagnosis & Therapy
https://www.readbyqxmd.com/read/28672074/collaborative-counseling-considerations-for-pharmacogenomic-tests
#4
Heather A Zierhut, Colleen A Campbell, Allison G Mitchell, Amy A Lemke, Rachel Mills, Jeffrey R Bishop
Increased use of pharmacogenomic (PGx) testing in the clinical setting has revealed a number of challenges to the provision of this service. PGx is an important component of precision medicine which brings together the fields of genetics and clinical pharmacology. A model that incorporates a multi-disciplinary approach to implementation and information delivery may be the most beneficial to patients and providers. In this review, translational considerations in the provision of PGx testing and counseling services are described...
July 3, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28669097/medical-education-in-pharmacogenomics-results-from-a-survey-on-pharmacogenetic-knowledge-in-healthcare-professionals-within-the-european-pharmacogenomics-clinical-implementation-project-ubiquitous-pharmacogenomics-u-pgx
#5
Katja Susanne Just, Michael Steffens, Jesse Joachim Swen, George P Patrinos, Henk-Jan Guchelaar, Julia Carolin Stingl
PURPOSE: Due to the diversity within Europe, the implementation of pharmacogenomic testing in clinical practice faces specific challenges. In the context of the European pharmacogenomics implementation project "Ubiquitous Pharmacogenomics" (U-PGx; funded by the European Commission), we studied the current educational background. METHODS: We developed a questionnaire including 29 questions. It was spread out to healthcare professionals working at the future implementation sites (in Austria, Greece, Italy, Netherlands, Slovenia, Spain and Great Britain) of the U-PGx project in preparation of an educational programme...
July 2, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28637770/analgesia-and-opioids-a-pharmacogenetics-shortlist-for-implementation-in-clinical-practice
#6
REVIEW
Maja Matic, Saskia N de Wildt, Dick Tibboel, Ron H N van Schaik
BACKGROUND: The use of opioids to alleviate pain is complicated by the risk of severe adverse events and the large variability in dose requirements. Pharmacogenetics (PGx) could possibly be used to tailor pain medication based on an individual's genetic background. Many potential genetic markers have been described, and the importance of genetic predisposition in opioid efficacy and toxicity has been demonstrated in knockout mouse models and human twin studies. Such predictors are especially of value for neonates and young children, in whom the assessment of efficacy or side effects is complicated by the inability of the patient to communicate this properly...
July 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/28619604/clinical-implementation-of-pharmacogenomics-for-personalized-precision-medicine-barriers-and-solutions
#7
REVIEW
Michelle Elizabeth Klein, Md Masud Parvez, Jae-Gook Shin
Clinical implementation of pharmacogenomics (PGx) leads to personalized medicine, which improves the efficacy, safety, and cost-effectiveness of treatments. Although PGx-based research has been conducted for more than a decade, several barriers have slowed down its widespread implementation in clinical practice. Globally, there is an imbalance in programs and solutions required to empower the clinical implementation of PGx between countries. Therefore, we aimed to review these issues comprehensively, determine the major barriers, and find the best solutions...
June 12, 2017: Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28607506/cost-effectiveness-of-pharmacogenetic-guided-treatment-are-we-there-yet
#8
REVIEW
M Verbelen, M E Weale, C M Lewis
Pharmacogenetics (PGx) has the potential to personalize pharmaceutical treatments. Many relevant gene-drug associations have been discovered, but PGx-guided treatment needs to be cost-effective as well as clinically beneficial to be incorporated into standard health-care. We reviewed economic evaluations for PGx associations listed in the US Food and Drug Administration (FDA) Table of Pharmacogenomic Biomarkers in Drug Labeling. We determined the proportion of evaluations that found PGx-guided treatment to be cost-effective or dominant over the alternative strategies, and estimated the impact on this proportion of removing the cost of genetic testing...
June 13, 2017: Pharmacogenomics Journal
https://www.readbyqxmd.com/read/28607504/on-the-readiness-of-physicians-for-pharmacogenomics-testing-an-empirical-assessment
#9
N Amara, J Blouin-Bougie, D Bouthillier, J Simard
This paper aims to explore the determinants of adoption of pharmacogenomics (PGx) testing by clinicians, and to assess whether this adoption differs with regard to area of specialization. Data were collected from a web-based survey among physicians in Québec (Canada). Our results highlighted that they perceived several benefits and had favorable attitudes toward PGx tests, but felt unprepared to use them. Results also show that practice specialties matter. Notably, being a family physician decreases the likelihood of adopting PGx tests...
June 13, 2017: Pharmacogenomics Journal
https://www.readbyqxmd.com/read/28546997/pharmacogenomic-findings-from-clinical-whole-exome-sequencing-of-diagnostic-odyssey-patients
#10
Margot A Cousin, Eric T Matey, Patrick R Blackburn, Nicole J Boczek, Tammy M McAllister, Teresa M Kruisselbrink, Dusica Babovic-Vuksanovic, Konstantinos N Lazaridis, Eric W Klee
BACKGROUND: We characterized the pharmacogenomics (PGx) results received by diagnostic odyssey patients as secondary findings during clinical whole exome sequencing (WES) testing as a part of their care in Mayo Clinic's Individualized Medicine Clinic to determine the potential benefits and limitations to this cohort. METHODS: WES results on 94 patients included a subset of PGx variants in CYP2C19,CYP2C9, and VKORC1 if identified in the patient. Demographic, phenotypic, and medication usage information was abstracted from patient medical data...
May 2017: Molecular Genetics & Genomic Medicine
https://www.readbyqxmd.com/read/28502727/concordance-between-research-sequencing-and-clinical-pharmacogenetic-genotyping-in-the-emerge-pgx-study
#11
Laura J Rasmussen-Torvik, Berta Almoguera, Kimberly F Doheny, Robert R Freimuth, Adam S Gordon, Hakon Hakonarson, Jared B Hawkins, Ammar Husami, Lynn C Ivacic, Iftikhar J Kullo, Michael D Linderman, Teri A Manolio, Aniwaa Owusu Obeng, Renata Pellegrino, Cynthia A Prows, Marylyn D Ritchie, Maureen E Smith, Sarah C Stallings, Wendy A Wolf, Kejian Zhang, Stuart A Scott
There has been extensive debate about both the necessity of orthogonal confirmation of next-generation sequencing (NGS) results in Clinical Laboratory Improvement Amendments-approved laboratories and return of research NGS results to participants enrolled in research studies. In eMERGE-PGx, subjects underwent research NGS using PGRNseq and orthogonal targeted genotyping in clinical laboratories, which prompted a comparison of genotyping results between platforms. Concordance (percentage agreement) was reported for 4077 samples tested across nine combinations of research and clinical laboratories...
July 2017: Journal of Molecular Diagnostics: JMD
https://www.readbyqxmd.com/read/28389049/intuitive-pharmacogenetic-dosing-of-risperidone-according-to-cyp2d6-phenotype-extrapolated-from-genotype-in-a-cohort-of-first-episode-psychosis-patients
#12
Sergi Mas, Patricia Gassó, Mercé Torra, Miquel Bioque, Antonio Lobo, Ana González-Pinto, Maria Soledad Olmeda, Iluminada Corripio, Eduard Vieta, Josefina Castro-Fornieles, Roberto Rodriguez-Jimenez, Julio Bobes, Judith Usall, Adrián Llerena, Jerónimo Saiz-Ruiz, Miguel Bernardo, Amalia Lafuente, PEPs Group
Risperidone (R) is the most prescribed antipsychotic drug for patients with a first episode of psychosis (FEP). In a naturalistic cohort of chronic psychiatric inpatients, we demonstrated that clinicians adjust R dosage by CYP2D6 activity, despite being blinded to the genotype, which we described as an "intuitive pharmacogenetic" process. The aim of the present study is to replicate our previous findings of intuitive pharmacogenetic in a cohort of FEP patients using CYP2D6 phenotype extrapolated from genotypes...
July 2017: European Neuropsychopharmacology: the Journal of the European College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28314093/clinical-impact-of-pharmacogenetic-guided-treatment-for-patients-exhibiting-neuropsychiatric-disorders-a-randomized-controlled-trial
#13
RANDOMIZED CONTROLLED TRIAL
Marilyn C Olson, Alejandra Maciel, Jean Francois Gariepy, Ali Cullors, Juan-Sebastian Saldivar, David Taylor, Joel Centeno, Jorge A Garces, Sandeep Vaishnavi
Objective: Pharmacogenetic testing holds promise as a personalized medicine tool by permitting individualization of pharmacotherapy in accordance with genes influencing therapeutic response, side effects, and adverse events. The authors evaluated the effect on outcomes for patients diagnosed with neuropsychiatric disorders of pharmacogenetics (PGx)-guided treatment compared to usual standard of care. Methods: This was a prospective, randomized study of 237 patients at an outpatient community-based psychiatric practice conducted between April 2015 and October 2015...
March 16, 2017: Primary Care Companion to CNS Disorders
https://www.readbyqxmd.com/read/28282716/personalized-medicine-pharmacogenomics-and-drug-development
#14
REVIEW
Somayeh Mirsadeghi, Bagher Larijani
Personalized medicine aims is to supply the proper drug to the proper patient within the right dose. Pharmacogenomics (PGx) is to recognize genetic variants that may influence drug efficacy and toxicity. All things considered, the fields cover a wide area, including basic drug discovery researches, the genetic origin of pharmacokinetics and pharmacodynamics, novel drug improvement, patient genetic assessment and clinical patient administration. At last, the objective of Pharmacogenomics is to anticipate a patient's genetic response to a particular drug as a way of presenting the best possible medical treatment...
March 2017: Acta Medica Iranica
https://www.readbyqxmd.com/read/28244804/assessing-feasibility-of-delivering-pharmacogenetic-testing-in-a-community-pharmacy-setting
#15
RANDOMIZED CONTROLLED TRIAL
Susanne B Haga, Jivan Moaddeb, Rachel Mills, Deepak Voora
AIM: To describe the rationale and design of a study evaluating the delivery of pharmacogenetic (PGx) testing in community pharmacies. Study rationale: Pharmacists have expressed interest in offering PGx testing; however, their lack of knowledge and experience, patients' acceptance and feasibility are unknown in this setting. STUDY DESIGN: Through a cluster randomized trial, we will assess pharmacist and patient experiences with delivery of PGx testing as a standalone service or integrated into medication therapy management services...
March 2017: Pharmacogenomics
https://www.readbyqxmd.com/read/28238356/economic-utility-combinatorial-pharmacogenomics-and-medication-cost-savings-for-mental-health-care-in-a-primary-care-setting
#16
Lisa C Brown, Raymond A Lorenz, James Li, Bryan M Dechairo
PURPOSE: This study was an analysis based on a previously completed prospective study investigating medication costs of patients with mental illness guided by using the GeneSight proprietary combinatorial pharmacogenomic (PGx) test. The primary objective of this study was to determine potential cost savings of combinatorial PGx testing over the course of 1 year in patients with mental illness treated by primary care providers (PCPs) and psychiatrists who had switched or added a new psychiatric medication after patients failed to respond to monotherapy...
February 18, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28223667/-molecular-diagnosis-and-treatment-of-hboc-syndrome
#17
Yoshio Miki
Hereditary breast and ovarian cancer(HBOC)is an inherited cancer caused by mutations of the BRCA1 or BRCA2 genes. BRCA genetic testing is used for HBOC diagnosis and continues to progress such as the annotation of VUS. In HBOC clinical practice, surveillance methods have been established through collaboration between genetic medicine and cancer medicine, and treatment, including options based on genetic diagnosis, has advanced significantly. Furthermore, the analysis of BRCA1 and BRCA2 function has progressed, and a novel therapeutic method based on synthetic lethality, such as a PARP inhibitor use, has been developed...
February 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28213088/personalized-medicine-genetic-risk-prediction-of-drug-response
#18
REVIEW
Ge Zhang, Daniel W Nebert
Pharmacogenomics (PGx), a substantial component of "personalized medicine", seeks to understand each individual's genetic composition to optimize drug therapy -- maximizing beneficial drug response, while minimizing adverse drug reactions (ADRs). Drug responses are highly variable because innumerable factors contribute to ultimate phenotypic outcomes. Recent genome-wide PGx studies have provided some insight into genetic basis of variability in drug response. These can be grouped into three categories. [a] Monogenic (Mendelian) traits include early examples mostly of inherited disorders, and some severe (idiosyncratic) ADRs typically influenced by single rare coding variants...
February 14, 2017: Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/28212353/effect%C3%A2-of%C3%A2-fibre%C3%A2-supplementation%C3%A2-on%C3%A2-body%C3%A2-weight%C3%A2-and%C3%A2-composition-%C3%A2-frequency%C3%A2-of%C3%A2-eating%C3%A2-and%C3%A2-dietary%C3%A2-choice%C3%A2-in%C3%A2-overweight%C3%A2-individuals
#19
Vicky A Solah, Deborah A Kerr, Wendy J Hunt, Stuart K Johnson, Carol J Boushey, Edward J Delp, Xingqiong Meng, Roland J Gahler, Anthony P James, Aqif S Mukhtar, Haelee K Fenton, Simon Wood
Fibre supplementation can potentially reduce energy intake and contribute to weight loss. The mechanism may be reduced frequency of eating, resulting in reduced food consumption. The objective of this research was to determine the effectiveness of fibre supplementation with PolyGlycopleX® (PGX®), on body weight and composition, frequency of eating and dietary intake in 118 overweight adults. In a three-arm, parallel, blind, randomised controlled trial participants were randomised to one of three groups; 4...
February 16, 2017: Nutrients
https://www.readbyqxmd.com/read/28176639/personalized-medicine-in-the-paediatric-population-the-balance-between-pharmacogenetics-progress-and-bioethics
#20
Stefania Schiavone, Margherita Neri, Cristoforo Pomara, Irene Riezzo, Luigia Trabace, Emanuela Turillazzi
Personalized medicine (PM) is becoming increasingly important in contemporary clinical and research scenarios. In the context of PM, pharmacogenomics and pharmacogenetics are aimed at the genetic personalization of drug response. Extrinsic and intrinsic factors may explain inter-individual variability in drug response. Among such factors, age seems to specifically intervene to modulate drug response since normal developmental changes may influence the exposure-response relation. Consequently, the potential benefit of pharmacogenomics (PGx) in the paediatric population is considerable...
February 7, 2017: Current Pharmaceutical Biotechnology
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