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Nine-gene pharmacogenomics profile service: The Mayo Clinic experience

The Pharmacogenomics Journal volume 22, pages 69–74 (2022)Cite this article

Subjects

Abstract

Purpose

The Pharmacogenomics (PGx) Profile Service was a proof-of-concept project to implement PGx in patient care at Mayo Clinic.

Methods

Eighty-two healthy individuals aged 18 and older underwent genotyping of CYP1A2, CYP2C9, CYP2C19, CYP2D6, CYP3A4, CYP3A5, SLCO1B1, HLA-B*58:01, and VKORC1. A PGx pharmacist was involved in ordering, meeting with patients, interpreting, reviewing, and documenting results.

Results

Ninety three percent were CYP1A2 rapid metabolizers, 92% CYP3A4 normal metabolizers, and 88% CYP3A5 poor metabolizers; phenotype frequencies for CYP2C19 and CYP2D6 varied. Seventy-three percent had normal functioning SLCO1B1 transporter, 4% carried the HLA-B*58:01 risk variant, and 35% carried VKORC1 and CYP2C9 variants that increased warfarin sensitivity.

Conclusion

Pre-emptive PGx testing offered medication improvement opportunity in 56% of participants for commonly used medications. A collaborative approach involving a PGx pharmacist integrated within a clinical practice with regards to utility of PGx results allowed for implementation of the PGx Profile Service.

Key points

  • The Mayo Clinic PGx (PGx) Profile Service was a proof-of-concept project to utilize PGx testing as another clinical tool to enhance medication selection and decrease serious adverse reactions or medication failures.

  • Over one-half of participants in the pilot using the PGx Profile Service were predicted to benefit from pre-emptive PGx testing to guide pharmacotherapy.

  • PGx pharmacists played a crucial role in the PGx Profile Service by educating participants, identifying medication-gene interactions, and providing evidence-based (CPIC and DPWG) PGx recommendations for past, current, and future medication us.

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Fig. 1: Methods and Workflow.

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Funding

This work was supported by the Mayo Clinic Center for Individualized Medicine.

Author information

Authors and Affiliations

  1. Department of Pharmacy, Mayo Clinic, Rochester, MN, USA

    Eric T. Matey, Ashley Kate Ragan, Lance J. Oyen & Sofia Shrestha

  2. Center for Individualized Medicine, Mayo Clinic, Rochester, MN, USA

    Eric T. Matey, Carolyn R. Vitek, Stacy L. Aoudia, Ahmed K. Ragab, Kelliann C. Fee-Schroeder, Tammy M. McAllister & Konstantinos N. Lazaridis

  3. Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA

    John L. Black & Ann M. Moyer

  4. Mayo Clinic College of Medicine, Mayo Clinic, Rochester, MN, USA

    Wayne T. Nicholson

  5. Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, MN, USA

    Wayne T. Nicholson

  6. Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA

    Jason P. Sinnwell

  7. Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA

    Stephanie S. Faubion

  8. Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA

    Konstantinos N. Lazaridis

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Contributions

ETM, AKR, WTN, and SS wrote the paper; ETM, CRV, AKR, and TMM designed the research; ETM, LJO, SLA, KCF, SSF, and KNL performed the research; AMM, JLB, and JPS analyzed the data.

Corresponding author

Correspondence to Eric T. Matey.

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Competing interests

JLB has stock ownership and has licensed intellectual property to OneOme LLC and receives royalties from AssureX health. The Mayo Clinic Laboratory provides pharmacogenetic testing. In addition, Mayo Clinic has stock ownership and has licensed intellectual property to OneOme LLC and receives royalties from AssureX health. All remaining authors declare no conflicts of interest.

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Matey, E.T., Ragan, A.K., Oyen, L.J. et al. Nine-gene pharmacogenomics profile service: The Mayo Clinic experience. Pharmacogenomics J 22, 69–74 (2022). https://doi.org/10.1038/s41397-021-00258-0

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