Pharmacogenomics and stratified medicine

Padmanabhan, S. (2014) Pharmacogenomics and stratified medicine. In: Padmanabhan, S. (ed.) Handbook of Pharmacogenomics and Stratified Medicine. Academic Press: London, pp. 3-25. ISBN 9780123868831 (doi: 10.1016/B978-0-12-386882-4.00001-3)

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Interindividual variation of drug response is caused by a combination of genetic and environmental factors as well as patient characteristics that can affect the pharmacokinetics and/or pharmacodynamics of drugs. For drug response phenotypes, it is estimated that 20 to 95 percent of variability in drug disposition and effects may be due to genetic factors and support the notion that access to information on an individual’s drug efficacy or toxicity predisposition will enable targeted therapy and avoid all the drawbacks of the current trial and error approach. Furthermore, the rapid advances in genomics and molecular biology are revealing the presence of distinct sub-populations within particular clinical presentations that may be amenable to specific therapies. Classification of patients into these subtypes of disease using diagnostic markers adds another dimension to tailored therapy, where accurate definition of the disease subtype can lead to a targeted approach. Pharmacogenomics and stratified medicine are part of the continuum of drug development and clinical implementation towards reduced dependence on “trial-and-error medicine” and improved the efficiency and effectiveness of health-care delivery. Stratified medicine adds a step to traditional clinical practice, and instead of proceeding to treat all patients, it uses baseline information about a patient’s likely response to treatment to formulate treatment decisions. There are significant clinical, financial and ethical barriers to the successful implementation of pharmacogenomics. This chapter provides a broad overview of pharmacogenomics and stratified medcine in relation to the current state of the art.

Item Type:Book Sections
Glasgow Author(s) Enlighten ID:Padmanabhan, Professor Sandosh
Authors: Padmanabhan, S.
Subjects:R Medicine > RM Therapeutics. Pharmacology
College/School:College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health
Publisher:Academic Press
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