Opening Pandora’s box in the UK: a hypothetical pharmacogenetic test for clozapine-Reference-Cited by-同舟云学术

Opening Pandora’s box in the UK: a hypothetical pharmacogenetic test for clozapine

Published:2013-11 Issue:15 Volume:14 Page:1907-1914
ISSN:1462-2416
Container-title:Pharmacogenomics
language:en
Short-container-title:Pharmacogenomics

Author:

Spencer Benjamin WJ¹,Prainsack Barbara²,Rujescu Dan³,Giegling Ina³,Collier David A⁴⁵,Gaughran Fiona⁶⁴,MacCabe James H⁶⁴,Barr Cathy L⁷⁸,Sigurdsson Engilbert⁹¹⁰,Stovring Henrik¹¹,Malhotra Anil K¹²¹³,Curran Sarah R⁶⁴

Affiliation:

1. South London & Maudsley NHS Foundation Trust, London, UK.

2. Department of Social Science, Health & Medicine, King’s College London, London, UK.

3. Department of Psychiatry, University of Halle, Germany.

4. Institute of Psychiatry, King’s College London, London, UK.

5. Eli Lilly & Company Ltd, Erl Wood, UK.

6. South London & Maudsley NHS Foundation Trust, London, UK

7. The Toronto Western Research Institute, Toronto, ON, Canada.

8. The Hospital for Sick Children, Toronto, ON, Canada.

9. University of Iceland, Reykjavik, Iceland.

10. Department of Psychiatry, Landspitali-University Hospital, Reykjavik, Iceland.

11. Department of Public Health, Aarhus University, Denmark.

12. The Zucker Hillside Hospital, Glen Oaks, NY, USA.

13. Hofstra North Shore-LIJ School of Medicine, Hemptead, NY, USA.

Abstract

Clozapine is a uniquely efficacious antipsychotic drug in treatment-resistant schizophrenia. Its use is restricted due to adverse effects including a rare but dangerous reduction in neutrophils (agranulocytosis) and the mandatory hematological monitoring this entails in many countries. We review the statistical, ethical and legal issues arising from a hypothetical pharmacogenetic test for clozapine, using the UK as an exemplary case for consideration. Our key findings include: a consideration of the probabilistic results that a pharmacogenetic test may return; the impact on drug licensing; and the potential for pharmacogenetic tests for clozapine being used without consent under the UK’s legal framework. We make recommendations regarding regulatory changes applicable to the special case of pharmacogenetic testing in clozapine treatment.

Publisher

Future Medicine Ltd

Subject

Pharmacology,Genetics,Molecular Medicine

Link

https://www.futuremedicine.com/doi/pdf/10.2217/pgs.13.182

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