Perception of the Usefulness of Drug/Gene Pairs and Barriers for Pharmacogenomics in Latin America
Luis Abel Quinones, Maria Alejandra Lavanderos, Juan Pablo Cayun, Elena Garcia-Martin, Jose Augusto Agundez, Dante Daniel Caceres, Angela Margarita Roco, Jorge E. Morales, Luisa Herrera, Gonzalo Encina, Carlos Alberto Isaza, Maria Ana Redal, Laura Larovere, Nestor Walter Soria, Javier Eslava-Schmalbach, Gilberto Castaneda-Hernandez, Andres Lopez-Cortes, Luiz Alexandre Magno, Marisol Lopez, Miguel Angel Chiurillo, Idania Rodeiro, Dinorah Castro de Guerra, Enrique Teran, Francisco Estevez-Carrizo and Ismael Lares-Assef
Affiliation: Laboratory of Chemical Carcinogenesis and Pharmacogenetics, IFT, Molecular and Clinical Pharmacology Program, ICBM, Faculty of Medicine, University of Chile; P.O. Box 70111. Carlos Schachtebeck 299, Quinta Normal, Santiago, Chile.
Pharmacogenetics and Pharmacogenomics areas are currently emerging fields focused to manage pharmacotherapy that may
prevent undertreatment while avoiding associated drug toxicity in patients. Large international differences in the awareness and in the use
of pharmacogenomic testing are presumed, but not well assessed to date. In the present study we review the awareness of Latin American
scientific community about pharmacogenomic testing and the perceived barriers for their clinical application. In order to that, we have
compiled information from 9 countries of the region using a structured survey which is compared with surveys previously performed in
USA and Spain.
The most relevant group of barriers was related to the need for clear guidelines for the use of pharmacogenomics in clinical practice, followed
by insufficient awareness about pharmacogenomics among clinicians and the absence of regulatory institutions that facilitate the
use of pharmacogenetic tests.
The higher ranked pairs were TPMT/thioguanine, TPMT/azathioprine, CYP2C9/warfarin, UGT1A1/irinotecan, CYP2D6/amitriptiline,
CYP2C19/citalopram and CYP2D6/clozapine. The lower ranked pairs were SLCO1B1/simvastatin, CYP2D6/metoprolol and
GP6D/chloroquine. Compared with USA and Spanish surveys, 25 pairs were of lower importance for Latin American respondents. Only
CYP2C19/esomeprazole, CYP2C19/omeprazole, CYP2C19/celecoxib and G6PD/dapsone were ranked higher or similarly to the USA
and Spanish surveys.
Integration of pharmacogenomics in clinical practice needs training of healthcare professionals and citizens, but in addition legal and
regulatory guidelines and safeguards will be needed. We propose that the approach offered by pharmacogenomics should be incorporated
into the decision-making plans in Latin America.
Keywords: Adverse drug reactions, biomarkers, clinical recommendations, clinical relevance, pharmacogenomics.
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