Pharmakogenomik in der Praxis

Zusammenfassung

Die Pharmakogenomik befasst sich mit erblich bedingten vor- oder nachteiligen Unterschieden des Ansprechens auf Medikamente. Innerhalb der letzten 10 Jahre häuften sich vor allem in kleinen Studien die Evidenz für einen genetischen Einfluss auf das Ansprechen auf Medikamente. Die Auswirkungen auf das praktische Arbeiten werden allerdings noch immer diskutiert.

In diesem Beitrag sollen etablierte Beispiele dargestellt werden, bie denen pharmakogenetische Techniken die tägliche Arbeit erleichtern können. Die Beispiele beinhalten die Genotypisierung von CYP2D6 in der Antidepressiva-Therapie, die Analyse von TPMT-Varianten für Vorhersage von Mercaptopurin-induziertem Rückgang des Knochenmarks, VKORC1- und CYP2C9-Analysen um die Antikoagulanzien-Gabe besser zu kontrollieren sowie SLCO1B1-Varienten bei Statin-induzierten Myopathien.

Abstract

Pharmacogenomics investigates inherited differences in drug responses including beneficial and adverse reactions. While a considerable amount of evidence for genetic influences on drug responses has been accumulated within the last decade, predominantly in small studies, its value in routine therapy is still a matter of debate.

The aim of this review is to discuss well established examples where pharmacogenomic techniques can improve routine treatment. Examples include genotyping of CYP2D6 in the context of antidepressant therapy, analysis of TPMT variants for the prediction of mercaptopurine-induced bone marrow depression, VKORC1 and CYP2C9 analyses for a better control of anticoagulant administration and the SLCO1B1 variant in the context of statin-induced myopathies.

Schlüsselwörter

Pharmakogenetik - Pharmakogenomik - Thiopurinmethyltransferase (TPMT) - Arzneimitteltransport - Cytochrom P450 2D6 - Rhabdomyolyse, statininduziert - SLCO1B1

Keywords

pharmacogenetics - pharmacogenomics - thiopurine Methyltransferase (TPMT) - drug Transport - cytochrome P450 2D6 - rhabdomyolysis, statin-induced - SLCO1B1

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