Pharmacogenomics Implementation at the National Institutes of Health Clinical Center. (15th September 2017)

• Record Type: Journal Article
• Authors: Sissung, Tristan M.; McKeeby, Jon W.; Patel, Jharana; Lertora, Juan J.; Kumar, Parag; Flegel, Willy A.; Adams, Sharon D.; Eckes, Ellen J.; Mickey, Frank; Plona, Teri M.; Mellott, Stephanie D.; Baugher, Ryan N.; Wu, Xiaolin; Soppet, Daniel R.; Barcus, Mary E.; Datta, Vivekananda; Pike, Kristen M.; DiPatrizio, Gary; Figg, William D.; Goldspiel, Barry R.
• Other Names: Lee Lucy guestEditor.; Lewis Lionel D. guestEditor.
• Is Part Of: Journal of clinical pharmacology. Volume 57(2017)Supplement 10
• Page Start: S67
• Page End: S77
• Publication Date: 2017-09-15
• Subjects: pharmacogenomics -- implementation -- precision medicine -- translation; Pharmacology -- Periodicals; Pharmacology -- Periodicals; Pharmacology, Clinical -- Periodicals; 615.1
• DOI: 10.1002/jcph.993
• Languages: English
• ISSNs: 0091-2700

Abstract

Abstract: The National Institutes of Health Clinical Center (NIH CC) is the largest hospital in the United States devoted entirely to clinical research, with a highly diverse spectrum of patients. Patient safety and clinical quality are major goals of the hospital, and therapy is often complicated by multiple cotherapies and comorbidities. To this end, we implemented a pharmacogenomics program in 2 phases. In the first phase, we implemented genotyping for HLA‐A and HLA‐B gene variations with clinical decision support (CDS) for abacavir, carbamazepine, and allopurinol. In the second phase, we implemented genotyping for drug‐metabolizing enzymes and transporters: SLCO1B1 for CDS of simvastatin and TPMT for CDS of mercaptopurine, azathioprine, and thioguanine. The purpose of this review is to describe the implementation process, which involves clinical, laboratory, informatics, and policy decisions pertinent to the NIH CC.