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Determining the potential clinical value of panel-based pharmacogenetic testing in patients with chronic pain or gastroesophageal reflux disease

Abstract

We aimed to determine the potential value of panel-based pharmacogenetic (PGx) testing in patients with chronic pain or gastroesophageal reflux disease (GERD) who underwent single-gene PGx testing to guide opioid or proton pump inhibitor (PPI) therapy, respectively. Of 448 patients included (chronic pain, n = 337; GERD, n = 111), mean age was 57 years, 68% were female, and 73% were white. Excluding opiates for the pain cohort and PPIs for the GERD cohort, 76.6% of patients with pain and 71.2% with GERD were prescribed at least one additional medication with a high level of PGx evidence, most commonly ondansetron or selective serotonin reuptake inhibitors. The most common genes that could inform PGx drug prescribing were CYP2C19, CYP2D6, CYP2C9, and SLCO1B1. Our findings suggest that patients with chronic pain or GERD are commonly prescribed drugs with a high level of evidence for a PGx-guided approach, supporting panel-based testing in these populations.

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Fig. 1: Percent of patients prescribed PGx medications excluding the target drug.
Fig. 2: Most commonly prescribed PGx medications excluding the target drug.
Fig. 3: Genes for PGx medications prescribed outside of the target drug.
Fig. 4: Percent of patients prescribed additional gene-specific PGx medications.

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Acknowledgements

NIH/NCATS UF CTSA UL1 TR000064 and UL1TR001427, IGNITE Network grant U01 HG007269, and substantial institutional support from University of Florida and University of Florida Health. We would also like to thank the following physicians for their efforts Elvira Mercado, Jeffrey Budd, Melanie Hagen, Ashleigh Wright, and Ying Nagoshi.

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Correspondence to Larisa H. Cavallari.

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Elchynski, A.L., Cicali, E.J., Ferrer del Busto, M.C. et al. Determining the potential clinical value of panel-based pharmacogenetic testing in patients with chronic pain or gastroesophageal reflux disease. Pharmacogenomics J 21, 657–663 (2021). https://doi.org/10.1038/s41397-021-00244-6

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