Diabetes: Is there a future for Pharmacogenomics guided treatment?

Ewan Pearson (Lead / Corresponding author)

Research output: Contribution to journalArticle

1 Citation (Scopus)
33 Downloads (Pure)

Abstract

Diabetes is a disease defined on the basis of hyperglycaemia. There are monogenic forms of diabetes where defining the genetic cause has a dramatic impact on treatment ‐ with patients being able to transition from insulin to sulphonylureas. However, the majority of diabetes is type 2 diabetes. This review outlines the robust evidence accrued to date for pharmacogenetics of metformin, sulphonylureas, thiazolidinediones and DPP4 inhibitors, but highlights that these variants will only be of clinical utility when the genotype is already known at the point of prescribing. The future of pharmacogenetics in diabetes and other common complex disease relies on a paradigm shift ‐ that of pre‐emptive panel genotyping and use of clinical decision support tools to assimilate this genetic information with other clinical phenotypic data and to present this information simply to the prescriber. Given the recent dramatic fall in genotyping costs, this future is not far off.
Original languageEnglish
Pages (from-to)329-337
Number of pages9
JournalClinical Pharmacology & Therapeutics
Volume106
Issue number2
Early online date23 Apr 2019
DOIs
Publication statusPublished - Aug 2019

Fingerprint

Pharmacogenetics
Clinical Decision Support Systems
Thiazolidinediones
Metformin
Hyperglycemia
Type 2 Diabetes Mellitus
Genotype
Insulin
Costs and Cost Analysis
Therapeutics

Cite this

@article{3fd1d047954142959afab7c7448a527d,
title = "Diabetes: Is there a future for Pharmacogenomics guided treatment?",
abstract = "Diabetes is a disease defined on the basis of hyperglycaemia. There are monogenic forms of diabetes where defining the genetic cause has a dramatic impact on treatment ‐ with patients being able to transition from insulin to sulphonylureas. However, the majority of diabetes is type 2 diabetes. This review outlines the robust evidence accrued to date for pharmacogenetics of metformin, sulphonylureas, thiazolidinediones and DPP4 inhibitors, but highlights that these variants will only be of clinical utility when the genotype is already known at the point of prescribing. The future of pharmacogenetics in diabetes and other common complex disease relies on a paradigm shift ‐ that of pre‐emptive panel genotyping and use of clinical decision support tools to assimilate this genetic information with other clinical phenotypic data and to present this information simply to the prescriber. Given the recent dramatic fall in genotyping costs, this future is not far off.",
author = "Ewan Pearson",
note = "Funding: Wellcome Trust New Investigator Award 102820/Z/13/Z .",
year = "2019",
month = "8",
doi = "10.1002/cpt.1484",
language = "English",
volume = "106",
pages = "329--337",
journal = "Clinical Pharmacology & Therapeutics",
issn = "0009-9236",
publisher = "American Society for Clinical Pharmacology and Therapeutics",
number = "2",

}

Diabetes : Is there a future for Pharmacogenomics guided treatment? / Pearson, Ewan (Lead / Corresponding author).

In: Clinical Pharmacology & Therapeutics, Vol. 106, No. 2, 08.2019, p. 329-337.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Diabetes

T2 - Is there a future for Pharmacogenomics guided treatment?

AU - Pearson, Ewan

N1 - Funding: Wellcome Trust New Investigator Award 102820/Z/13/Z .

PY - 2019/8

Y1 - 2019/8

N2 - Diabetes is a disease defined on the basis of hyperglycaemia. There are monogenic forms of diabetes where defining the genetic cause has a dramatic impact on treatment ‐ with patients being able to transition from insulin to sulphonylureas. However, the majority of diabetes is type 2 diabetes. This review outlines the robust evidence accrued to date for pharmacogenetics of metformin, sulphonylureas, thiazolidinediones and DPP4 inhibitors, but highlights that these variants will only be of clinical utility when the genotype is already known at the point of prescribing. The future of pharmacogenetics in diabetes and other common complex disease relies on a paradigm shift ‐ that of pre‐emptive panel genotyping and use of clinical decision support tools to assimilate this genetic information with other clinical phenotypic data and to present this information simply to the prescriber. Given the recent dramatic fall in genotyping costs, this future is not far off.

AB - Diabetes is a disease defined on the basis of hyperglycaemia. There are monogenic forms of diabetes where defining the genetic cause has a dramatic impact on treatment ‐ with patients being able to transition from insulin to sulphonylureas. However, the majority of diabetes is type 2 diabetes. This review outlines the robust evidence accrued to date for pharmacogenetics of metformin, sulphonylureas, thiazolidinediones and DPP4 inhibitors, but highlights that these variants will only be of clinical utility when the genotype is already known at the point of prescribing. The future of pharmacogenetics in diabetes and other common complex disease relies on a paradigm shift ‐ that of pre‐emptive panel genotyping and use of clinical decision support tools to assimilate this genetic information with other clinical phenotypic data and to present this information simply to the prescriber. Given the recent dramatic fall in genotyping costs, this future is not far off.

U2 - 10.1002/cpt.1484

DO - 10.1002/cpt.1484

M3 - Article

C2 - 31012484

VL - 106

SP - 329

EP - 337

JO - Clinical Pharmacology & Therapeutics

JF - Clinical Pharmacology & Therapeutics

SN - 0009-9236

IS - 2

ER -