Clinical Pharmacology & Therapeutics - Pharmacogenetics: Call to Action

Letters to the Editor

Clinical Pharmacology & Therapeutics (2011); advance online publication 31 August 2011. doi:10.1038/clpt.2011.172

Pharmacogenetics: Call to Action

M V Relling¹, H J Guchelaar², D M Roden³ and T E Klein⁴

1. ¹Department of Pharmaceutical Sciences, St Jude Children's Research Hospital, Memphis, Tennessee, USA
2. ²Department of Clinical Pharmacy, Leiden University Medical Center, Leiden, The Netherlands
3. ³Department of Pharmacology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
4. ⁴Department of Genetics, Stanford University Medical Center, Stanford, California, USA

Correspondence: MV Relling, (mary.relling@stjude.org)

To the Editor: In their paper, “Pharmacogenetic Testing: Time for Clinical Practice Guidelines,” Amstutz and Carleton¹ published a “call to action” for developing clinical pharmacogenetics guidelines. We agree that there is growing interest in and need for freely available guidelines on pharmacogenetic testing for clinical use.

Clinical Pharmacology & Therapeutics readers may not yet be familiar with the Clinical Pharmacogenetics Implementation Consortium (CPIC),² a collaborative effort of the National Institutes of Health Pharmacogenomics Research Network (PGRN; http://www.pgrn.org) and the Pharmacogenomics Knowledge Base (PharmGKB; http://www.pharmgkb.org). Part of CPIC's mission is to critically evaluate the evidence in the published literature and develop peer-reviewed guidelines and recommendations for implementing specific pharmacogenomic tests and practices. This international consortium has published its first practice guideline,³ and future guidelines are in press with CPT and in preparation. Each guideline links specific gene–drug pairs, with an emphasis on genes for which reliable, clinically compliant assays are already available. The key attributes of these guidelines are that they are freely available (on http://www.pharmgkb.org) simultaneous with their publication, that the evidence for and strength of dosing recommendations are graded using uniform scales, and that mechanisms are in place for updating the guidelines as new evidence emerges. The Pharmacogenetics Working Group of the Royal Dutch Association for the Advancement of Pharmacy has also established a rich set of clinical guidelines for implementing pharmacogenetics⁴ and is working with CPIC to determine how to join forces and consolidate efforts to develop and update guidelines that will be useful to the international community.

CPIC is open to and engaged in collaborations with other groups worldwide to develop and maintain these guidelines, promote thoughtful implementation of pharmacogenetics, and provide leadership in the field by building consensus where possible. We invite the clinical pharmacology community to join us in this effort.

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Conflict of interest

M.V.R. receives a portion of the income that St Jude receives from licensing patent rights related to TPMT and GGH polymorphisms; she also receives funding for investigator-initiated research from Sigma-Tau Pharmaceuticals. The other authors declared no conflict of interest.

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References

1. Amstutz, U. & Carleton, B.C. Pharmacogenetic testing: time for clinical practice guidelines. Clin. Pharmacol. Ther. 89, 924–927 (2011). | Article | PubMed |
2. Relling, M.V. & Klein, T.E. CPIC: Clinical Pharmacogenetics Implementation Consortium of the Pharmacogenomics Research Network. Clin. Pharmacol. Ther. 89, 464–467 (2011). | Article | PubMed | ISI |
3. Relling, M.V. et al. Clinical Pharmacogenetics Implementation Consortium guidelines for thiopurine methyltransferase genotype and thiopurine dosing. Clin. Pharmacol. Ther. 89, 387–391 (2011). | Article | PubMed | ISI | ChemPort |
4. Swen, J.J. et al. Pharmacogenetics: from bench to byte–an update of guidelines. Clin. Pharmacol. Ther. 89, 662–673 (2011). | Article | PubMed |

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