| Personalized approaches to clopidogrel therapy: are we there yet? | |
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MedLine Citation:
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PMID: 21030701 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Clopidogrel is one of the most commonly prescribed medications worldwide. Recent advisories from the US Food and Drug Administration have drawn attention to the possibility of personalized decision-making for people who are candidates for clopidogrel. As is the case with antihypertensives, statins, and warfarin, common genetic sequence variants can influence clopidogrel metabolism and its effect on platelet activity. These genetic variants have, in multiple studies, been associated with adverse clinical outcomes. Concurrent medication use also influences how the body handles clopidogrel. Proton pump inhibitors, widely prescribed in conjunction with clopidogrel, may blunt its effectiveness. We address implications for bedside decision-making in light of accumulated data and current Food and Drug Administration advisories and conclude that genetic testing for CYP2C19 genotype and limitation of proton pump inhibitor interactions do not yet appear to offer an opportunity to optimize treatment given the current state of knowledge. |
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Authors:
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Christopher D Anderson; Alessandro Biffi; Steven M Greenberg; Jonathan Rosand |
Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review Date: 2010-10-28 |
Journal Detail:
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Title: Stroke; a journal of cerebral circulation Volume: 41 ISSN: 1524-4628 ISO Abbreviation: Stroke Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-11-30 Completed Date: 2010-12-22 Revised Date: 2013-05-27 |
Medline Journal Info:
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Nlm Unique ID: 0235266 Medline TA: Stroke Country: United States |
Other Details:
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Languages: eng Pagination: 2997-3002 Citation Subset: IM |
Affiliation:
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Division of Neurocritical Care and Emergency Neurology, Stroke Service, Center for Human Genetic Research, Massachusetts General Hospital, Boston, MA, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aryl Hydrocarbon Hydroxylases
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genetics Blood Coagulation / drug effects, genetics Clinical Trials as Topic Humans Individualized Medicine / methods* Platelet Aggregation Inhibitors / pharmacokinetics, therapeutic use* Ticlopidine / analogs & derivatives*, pharmacokinetics, therapeutic use |
| Grant Support | |
ID/Acronym/Agency:
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R01 NS059727/NS/NINDS NIH HHS; R01 NS059727-02/NS/NINDS NIH HHS; R01 NS059727-03/NS/NINDS NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Platelet Aggregation Inhibitors; 55142-85-3/Ticlopidine; A74586SNO7/clopidogrel; EC 1.14.14.1/Aryl Hydrocarbon Hydroxylases; EC 1.14.14.1/CYP2C19 protein, human |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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