Abstract
This study analyzed clinically actionable pharmacogenotypes for clopidogrel, warfarin, statins, thiopurines, and tacrolimus using microarray data for 2121 participants (55–85 years) from the Australian Hunter Community Study (HCS). At least 74% of participants (95% confidence interval [CI]: 72%–76%) had strong level evidence for at least one medium- or high-risk actionable genotype that would trigger a change in standard therapy under current international recommendations. About 14% of these participants (95% CI: 12%–16%) were taking medication potentially affected by the genotype in question. Furthermore, ~2.6% of all participants with medication data (95% CI: 1.4%–3.8%) had a high-risk clinically actionable genotype for a medication to which they were exposed. This represents a considerable number of people at the population level. Although relationships between genotype and health outcomes remain contentious, pharmacogenotyping of multiple variants simultaneously may have considerable potential to improve medication safety and efficacy for older people in the community.
Acknowledgments
The authors would like to thank the men and women participating in the HCS as well as all the staff, investigators, and collaborators who have supported or been involved in the project to date. The authors also acknowledge the contributions of Mark McEvoy, Wayne Smith, Catherine D’Este, Janine Duke, Roseanne Peel, Peter Schofield, Julie Byles, David Henry, Ben Ewald, and Derek Smith. A special thanks to Alison Koschel and Debbie Quain who were instrumental in setting up the pilot study and initial phase of the project.
The University of Newcastle provided $300,000 from its Strategic Initiatives Fund and $600,000 from the Gladys M Brawn Senior Research Fellowship scheme; Vincent Fairfax Family Foundation, a private philanthropic trust, provided $195,000; The Hunter Medical Research Institute provided media support during the initial recruitment of participants; and Dr Anne Crotty, Prof. Rodney Scott and Associate Professor Levi provided financial support towards freezing costs for the long-term storage of participant blood samples.
Disclosure
The authors report no conflicts of interest in this work.