Table 2.
Simulation estimating PGx interventions enabled by other genes
| Medication | Actionable phenotype | Consequence | Supporting evidence | Unique patients w/ order | Actionable phenotype frequencya | Projected # of PGx interventionsc | |||
|---|---|---|---|---|---|---|---|---|---|
| Black | White | Hispanic | Study populationb | ||||||
| G6PD | |||||||||
| Hydroxychloroquine | G6PD deficient | Adverse reaction | CPIC | 431 | 9.50% | 0.40% | 1.50% | 4.18% | 18 |
| Glipizide | G6PD deficient | Adverse reaction | CPIC | 62 | 9.50% | 0.40% | 1.50% | 4.18% | 3 |
| Trimethoprim/sulfamethoxazole | G6PD deficient | Adverse reaction | CPIC | 46 | 9.50% | 0.40% | 1.50% | 4.18% | 2 |
| Levofloxacin | G6PD deficient | Adverse reaction | CPIC | 43 | 9.50% | 0.40% | 1.50% | 4.18% | 2 |
| Ciprofloxacin | G6PD deficient | Adverse reaction | CPIC | 40 | 9.50% | 0.40% | 1.50% | 4.18% | 2 |
| Moxifloxacin | G6PD deficient | Adverse reaction | CPIC | 30 | 9.50% | 0.40% | 1.50% | 4.18% | 1 |
| Nitrofurantoin | G6PD deficient | Adverse reaction | CPIC | 15 | 9.50% | 0.40% | 1.50% | 4.18% | 1 |
| Erythromycin | G6PD deficient | Adverse reaction | CPIC | 13 | 9.50% | 0.40% | 1.50% | 4.18% | 1 |
| Phenazopyridine | G6PD deficient | Adverse reaction | CPIC | 8 | 9.50% | 0.40% | 1.50% | 4.18% | 0 |
| Sulfadiazine | G6PD deficient | Adverse reaction | CPIC | 8 | 9.50% | 0.40% | 1.50% | 4.18% | 0 |
| Glimepiride | G6PD deficient | Adverse reaction | CPIC | 7 | 9.50% | 0.40% | 1.50% | 4.18% | 0 |
| Dapsone | G6PD deficient | Adverse reaction | CPIC | 3 | 9.50% | 0.40% | 1.50% | 4.18% | 0 |
| Quinidine | G6PD deficient | Adverse reaction | CPIC | 2 | 9.50% | 0.40% | 1.50% | 4.18% | 0 |
| Sulfasalazine | G6PD deficient | Adverse reaction | CPIC | 2 | 9.50% | 0.40% | 1.50% | 4.18% | 0 |
| Total (n = 1,852) | 30 | ||||||||
| Per 100 patients | 2 | ||||||||
| CYP2C9 | |||||||||
| Ibuprofen | PM | Adverse reaction | CPIC | 247 | 0.52% | 2.56% | 0.95% | 1.29% | 3 |
| Warfarin | VKORC1/CYP2C9 warfarin sensitive/highly sensitive | Adverse reaction | CPIC | 63 | 3.29% | 37.72% | 26.20% | 21.14% | 13 |
| Meloxicam | IM (AS = 1) or PM | Adverse reaction | CPIC | 12 | 5.49% | 16.32% | 8.97% | 9.96% | 1 |
| Dronabinol | IM or PM | Adverse reaction | FDA | 11 | 24.13% | 37.08% | 25.42% | 28.59% | 3 |
| Celecoxib | PM | Adverse reaction | CPIC | 8 | 0.52% | 2.56% | 0.95% | 1.29% | 0 |
| Phenytoin | IM or PM or HLA‐B*15:02 carrier | Adverse reaction | CPIC | 6 | 24.33% | 37.16% | 25.48% | 28.71% | 2 |
| Total (n = 1,852) | 23 | ||||||||
| Per 100 patients | 1 | ||||||||
| HLA‐A or HLA‐B | |||||||||
| Allopurinol | HLA‐B*58:01 carrier | Adverse reaction | CPIC | 42 | 7.63% | 2.62% | 1.79% | 4.26% | 2 |
| Carbamazepine | HLA‐B*15:02 or HLA‐A*31:01 carriers | Adverse reaction | CPIC | 7 | 2.15% | 5.68% | 10.40% | 5.79% | 0 |
| Oxcarbazepine | HLA‐B*15:02 or HLA‐A*31:01 carriers | Adverse reaction | CPIC | 6 | 2.15% | 5.68% | 10.40% | 5.79% | 0 |
| Abacavir | HLA‐B*57:01 carriers | Adverse reaction | CPIC | 5 | 0.20% | 6.36% | 2.52% | 2.85% | 0 |
| Total (n = 1,852) | 3 | ||||||||
| Per 100 patients | 0 | ||||||||
| Others | |||||||||
| Simvastatin | SLCO1B1 intermediate or low function | Adverse reaction | CPIC | 45 | 8.80% | 34.07% | 29.61% | 23.12% | 10 |
| Tacrolimus | CYP3A5 EM or IM | Decreased efficacy | CPIC | 27 | 70.06% | 14.27% | 31.57% | 40.72% | 11 |
| Azathioprine | TPMT IM or PM or NUDT15 IM or PM | Adverse reaction | CPIC | 5 | 7.32% | 9.34% | 18.15% | 11.28% | 1 |
| Atazanavir | UGT1A1 PM | Adverse reaction | CPIC | 1 | 36.67% | 19.92% | 30.66% | 29.57% | 0 |
| Irinotecan | UGT1A1 PM | Adverse reaction | FDA | 1 | 36.67% | 19.92% | 30.66% | 29.57% | 0 |
| Total (n = 1,852) | 23 | ||||||||
| Per 100 patients | 1 | ||||||||
AS, activity score; CPIC, Clinical Pharmacogenetics Implementation Consortium; EM, extensive metabolizer; FDA, US Food and Drug Administration; IM, intermediate metabolizer; NM, normal metabolizer; PGx, pharmacogenomics; PM, poor metabolizer; RM, rapid metabolizer; UM, ultra‐rapid metabolizer.
Actionable phenotype population frequencies by ancestry extracted from CPIC guideline appendices; G6PD phenotype frequencies extracted from PMID 31860324; warfarin sensitive phenotype based on CYP2C9 and VKORC1, phenotype frequencies extracted from PMID 28689179 and PMID 21185752.
Study population frequency based is based on proportion of Black, White, and Hispanic values of self‐reported race (excluding unknown and other races): 38% Black, 31% White, and 31% Hispanic.
Projected PGx interventions = Unique patients with order * Study population actionable phenotype frequency.