Preemptive Pharmacogenetic Testing: Insufficient Data Equal Unsatisfactory Guidance
Authors: Howard L. McLeod, Kim L. Isaacs
Journal: Annals of Internal Medicine (2011)

Editorials21 June 2011Preemptive Pharmacogenetic Testing: Insufficient Data Equal Unsatisfactory GuidanceHoward L. McLeod, PharmD and Kim L. Isaacs, MD, PhDHoward L. McLeod, PharmDFrom University of North Carolina, Chapel Hill, NC 27599. and Kim L. Isaacs, MD, PhDFrom University of North Carolina, Chapel Hill, NC 27599.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-154-12-201106210-00016 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The past decade has seen the emergence of tools for tailoring care to individual patients. Under the guise of personalized medicine, a host of drug-level assays and DNA, RNA, protein, and imaging tests promise to enhance clinical benefit by enabling clinicians to determine optimal therapies and dosages (1). These tools come at an opportune time, when health systems are under pressure to improve returns on the therapeutic investment. However, evidence on the clinical effectiveness and cost-effectiveness of preemptive testing is lacking.In this issue, Booth and colleagues (2) systematically review evidence (54 observational studies and 1 randomized trial) on a ...References1. Wang L, McLeod HL, Weinshilboum RM. Genomics and drug response. N Engl J Med. 2011;364:1144-53. [PMID: 21428770] CrossrefMedlineGoogle Scholar2. Booth RA, Ansari MT, Loit E, Tricco AC, Weeks L, Doucette S, et al. Assessment of thiopurine S-methyltransferase activity in patients prescribed thiopurines: a systematic review. Ann Intern Med. 2011;154:814-23. LinkGoogle Scholar3. McLeod HL, Siva C. The thiopurine S-methyltransferase gene locus—implications for clinical pharmacogenomics. Pharmacogenomics. 2002;3:89-98. [PMID: 11966406] CrossrefMedlineGoogle Scholar4. McLeod HL, Miller DR, Evans WE. Azathioprine-induced myelosuppression in thiopurine methyltransferase deficient heart transplant recipient [Letter]. Lancet. 1993;341:1151. 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[PMID: 20051673] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From University of North Carolina, Chapel Hill, NC 27599.Grant Support: By grants U01 GM63340, UL1RR025747, and P30 DK34987 from the National Institutes of Health.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M11-1137.Corresponding Author: Howard L. McLeod, PharmD, University of North Carolina Institute for Pharmacogenomics and Individualized Therapy, University of North Carolina at Chapel Hill, 120 Mason Farm Road, Genetic Medicine Building, Campus Box 7361, Chapel Hill, NC 27599-7361; e-mail, [email protected]edu.Current Author Addresses: Dr. McLeod: University of North Carolina Institute for Pharmacogenomics and Individualized Therapy, University of North Carolina at Chapel Hill, 120 Mason Farm Road, Genetic Medicine Building, Campus Box 7361, Chapel Hill, NC 27599-7361.Dr. Isaacs: Division of Gastroenterology and Hepatology, University of North Carolina at Chapel Hill, 130 Mason Farm Road, Bioinformatics Building, Campus Box 7080, Chapel Hill, NC 27599-7080. 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