#45: Clopidogrel pharmacogenomics: Challenges, controversies, and clinical implications with Dr Jessica Mega

Feb 10, 2012 14:35 EST

The issue of clopidogrel genomics and CYP2C19 genotyping came to a head with the recent JAMA meta-analysis that questioned the use of clopidogrel loss-of-function gene testing—controversially stating that there is no link between genotype and cardiovascular events. Dr Jessica Mega joins the show to shine light on the rapidly evolving field of clopidogrel pharmacogenomics, examine the scientific data—and the controversy—and share her recommendations for practitioners.

See also:

Holmes MV, Perel P, Shah T, et al. CYP2C19 genotype, clopidogrel metabolism, platelet function, and cardiovascular events. JAMA 2011; 306:2704-2714. Available here.

Analysis slams use of clopidogrel loss-of-function gene test; proponents fire back

An important miscue in clopidogrel pharmacogenomics

ELEVATE-TIMI 56: Clopidogrel 225 mg for patients with one loss-of-function allele

GRAVITAS gene study: CYP2C19*2 carriers do not respond to high-dose clopidogrel

Dr Mega has served as an advisor or consultant for AstraZeneca, Bristol-Myers Squibb, Gilead, Merck, and Sanofi-Aventis. She has received grants for clinical research from Accumetrics, Bayer, Bristol-Myers Squibb, Daiichi Sankyo, Johnson & Johnson, Nanosphere, Sanofi-Aventis, and Eli Lilly.

For Dr Harrington's disclosures, click here.