Pharmacogenomics of acetylsalicylic acid and other nonsteroidal anti-inflammatory agents: clinical implications
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REVIEW ARTICLE
Pharmacogenomics of acetylsalicylic acid and other nonsteroidal anti-inflammatory agents: clinical implications Eugenia Yiannakopoulou
Received: 16 November 2012 / Accepted: 30 January 2013 / Published online: 24 February 2013 # Springer-Verlag Berlin Heidelberg 2013
Abstract Purpose Pharmacogenomics investigates interindividual genetic variability in the DNA sequence of drug targets, drug-metabolizing enzymes or disease genes, RNA expression, or protein translation of genes affecting drug response and drug safety. Aspirin and other nonsteroidal antiinflammatory drugs (NSAIDs) are among the most commonly prescribed medications with well-documented variation in patient response in terms of efficacy and safety. This variation may in part be explained by pharmacogenomics. Methods In this paper I review data on the pharmacogenomics of aspirin and other NSAIDs focusing on clinical implications. Results Existing scientific evidence supports the pharmacogenomic basis of interindividual variation in treatment response to aspirin and NSAIDs, with clinical implications for antiplatelet action, cancer chemoprevention, and drug safety. However, further research efforts are needed before knowledge on the pharmacogenomics of aspirin and NSAIDs can be implemented in clinical practice. Conclusion The outcome of these research efforts would be anticipated to have added value for both science and society, contributing to the enhanced efficacy and safety of these agents through patient selection. Keywords Pharmacogenomics . Aspirin . Nonsteroidal anti-inflammatory agents . Antiplatelet activity . Chemoprevention . Safety
E. Yiannakopoulou (*) Department of Basic Medical Lessons, Faculty of Health and Caring Professions, Technological Educational Institute of Athens, Eleutheriou Benizelou 106, Kallithea, Athens 17676, Greece e-mail: [email protected] E. Yiannakopoulou e-mail: [email protected]
Introduction Interindividual variation in treatment response to standard doses of drug therapy can lead to treatment failure or to lifethreatening adverse drug reactions among patients receiving identical doses of the same drug. A drug’s activity is the result of its interaction with the proteins involved in absorption, distribution, metabolism, and elimination (ADME proteins) and the molecular drug targets or target pathways. Genetic variation in these proteins, i.e., single nucleotide polymorphisms (SNPs) in genes coding for metabolizing enzymes or drug transporters, might have a significant influence on the drug effect. Pharmacogenomics investigates interindividual genetic variability in the DNA sequence of drug targets, drug-metabolizing enzymes, and disease genes, RNA expression, or protein translation of genes affecting drug response and drug safety [1]. Although clinical trials that include thousands of patients may generally indicate the efficacy and lack of toxicity of the drugs being tested, it is well known that it is not possible to predict a priori whether an individual patient will respond to a given medication wi
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