Systematic review into the role of genomics in profiling overall drug performance and variability.

Abstract

Background and aim: The aim of this project was to conduct a systematic review of the current literature concerning the impact of genomics on drug performance and variability. The impact of genomics on drug performance is well pronounced, with variation in various Cytochrome P450 (CYP450) enzymes being significant. Due to this, within a large patient population treatment will only be successful for some. In addition, drug transporters regulate the movement of metabolites into and out of cells therefore, they can also influence drug performance. Clinical knowledge in such areas can be used to facilitate the possibility of individualized medicine, which attempts to tailor medication choices to suit the pharmacogenetic makeup of a patient; with the aims of increasing drug efficacy and reducing adverse events. Methods: A search using common terms was conducted of 5 key databases, with articles assessed for eligibility before inclusion in the review paper. A total of 11 studies were identified covering a combined 2,163 patients aged from 18 to over 70 years old. All studies recruited human patients for clinical trials focusing on the efficacy of a selected drug, with regards to their specific genetic variants such as CYP450 enzymes. Results and conclusion: A majority of the studies collected found a statistically significant impact for a particular genetic variant on drug performance; indicating that genomics is beneficial to future clinical practice. However, there is a need to assess the cost benefit implications of introducing genomic based testing across a wider healthcare network