RESUMO
Both the Clinical Pharmacogenetics Implementation Consortium (CPIC) and Dutch Pharmacogenetics Working Group provide therapeutic recommendations for well-known gene-drug pairs. Published recommendations show a high rate of concordance. However, as a result of different guideline development methods used by these two consortia, differences between the published guidelines exist. The aim of this paper is to compare both initiatives and explore these differences, with the objective to achieve harmonization.
Assuntos
Farmacogenética , Guias de Prática Clínica como Assunto , Medicina de Precisão , Testes Genéticos/métodos , Humanos , Países Baixos , Farmacogenética/métodos , Farmacogenética/normas , Padrões de Prática Médica , Medicina de Precisão/métodos , Medicina de Precisão/normas , Pesquisa Translacional Biomédica/métodos , Pesquisa Translacional Biomédica/normas , Estados UnidosRESUMO
The antiretroviral protease inhibitor atazanavir inhibits hepatic uridine diphosphate glucuronosyltransferase (UGT) 1A1, thereby preventing the glucuronidation and elimination of bilirubin. Resultant indirect hyperbilirubinemia with jaundice can cause premature discontinuation of atazanavir. Risk for bilirubin-related discontinuation is highest among individuals who carry two UGT1A1 decreased function alleles (UGT1A1*28 or *37). We summarize published literature that supports this association and provide recommendations for atazanavir prescribing when UGT1A1 genotype is known (updates at www.pharmgkb.org).