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0:00
Hello. My name is
Maria Jesús Arranz,
and I am the head of
the research laboratory
and the pharmacogenetics unit
at Fundació Docència i
Recerca Mútua Terrassa.
I'm a biologist by trade,
and I have more than
30 years' experience
in the pharmacogenetics
of psychiatry.
In this talk, I would
like to discuss
the implementation of
pharmacogenetic interventions
in clinical settings.
0:26
The talk will include
a brief introduction,
a summary of confirmed
pharmacogenetic markers
useful in psychiatry,
a description of the
existing barriers
for the clinical implementation
of pharmacogenetics
in psychiatry,
a revision of the current
evidence on the clinical
and economic benefits of
pharmacogenetic interventions,
as well as a description
of available guidelines
and protocols of interventions.
0:54
It is well-known that
pharmacogenetic variants
influence response
to pharmacotherapy.
Recent studies have proven that
pharmacogenetic variants
are present in everybody.
For instance, a large
study with samples
from the UK Biobank showed that
more than 90% of the population
carried genetic variants
in at least one of the
14 genes investigated.
1:18
The primary study conducted in
the United States showed that
more than 70% of patients
of pharmacotherapy
had genetic variants that
interacted with one or more
of the drugs they
had been prescribed,
and most of those
genetic variants had
a clinically significant effect.
Furthermore, more
than 40% of drugs
that were prescribed
by clinicians
were given to patients
with genetic variants
that may affect their
efficacy or safety.
The same study showed that
pharmacogenetic variants
affected pharmacotherapy
in all medical areas,
and that drug interactions
are particularly important
in psychiatry.
For example, pharmacogenetic
variants associated with
response to selective
serotonin reuptake inhibitors,
or SSRIs, antidepressants,
are present in more than
86% of the population.
It means that 45% of
patients receiving SSRIs,
antidepressants,
had genetic contraindications
in more than one gene
coding for metabolic
enzymes for the target,
whereas about 41%
of the patients had
genetic contraindications
in at least one gene.
Pharmacogenetic studies
have discovered
