Pharmacogenomics

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Pharmacogenomics

Week of 18 August 2026

9 articles

Geno'X Veille — genox-veille.fr

Key takeaways this week

►CYP2C19 — Randomized trial in 300 ischemic stroke patients: a pharmacist-led pathway with genotype-guided antiplatelet therapy lowers one-year hospitalizations (IRR = 0.700), though the effect of genotyping itself remains inseparable.
►CYP2D6 — In IGNITE ADOPT-PGx, adding tramadol to oxycodone raises postoperative opioid burden from 122.5 to 205.2 MME with no analgesic gain, including in normal metabolizers.
►DPYD — Grade 3-4 toxicity on XELOX despite negative routine genotyping: the intronic variant c.2766+3A>T causes exon 21 skipping, shown on messenger RNA.
►CYP2C19 and SLCO1B1 — Among 738,531 Our Future Health participants, 36.8% have already been dispensed a medicine matched to one of their actionable phenotypes, with the signal concentrated on these two genes.

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A multicomponent intervention incorporating CYP2C19 genotype-guided therapy and integrated pharmaceutical care reduces hospitalizations and improves adherence in ischemic stroke.

Ischemic stroke — genotype-guided antiplatelet therapy

CardiologyCPIC Level ADose recommendation

Front Neurol 2026· AugRead

Tramadol Co-Administration with Oxycodone or Hydrocodone Increases Opioid Burden without Improving Postoperative Pain Control.

Postoperative pain - tramadol-opioid combination

Adverse reactionDose recommendation

Clin Pharmacol Ther 2026· AugRead

Tacrolimus dose individualization in organ transplantation

Relevance-Based Score for MIPD Model Selection: Systematic Review and External Evaluation of popPK Tacrolimus Models in Adult Transplant Recipients.

Tacrolimus dose individualization in organ transplantation

Dose recommendation

CPT Pharmacometrics Syst Pharmacol 2026· AugRead

The variant c.2766+3A>T in DPYD leads to exon 21 skipping and is associated with DPD deficiency and severe fluoropyrimidine toxicity.

Dihydropyrimidine dehydrogenase deficiency and fluoropyrimidine toxicity

OncologyCPIC Level AAdverse reaction

Br J Clin Pharmacol 2026· AugRead

Polygenic and familial contributions to antidepressant continuation, switching, discontinuation and augmentation in the All of Us and Pharmlines cohorts

Depression — antidepressant treatment trajectories and polygenic scores

PsychiatryNew interaction

medRxiv 2026· AugRead

Genotype-predicted drug response phenotypes and their co-occurrence with dispensed medicines among 738,531 participants in the UK Our Future Health study

Pre-emptive pharmacogenomic testing in primary care

DiabetesPreemptive genotypingCPIC Level A

medRxiv 2026· AugRead

Using physiologically based pharmacokinetic modelling to optimize repaglinide and irbesartan dosing in Chinese population with SLCO1B1 polymorphism.

Type 2 diabetes and hypertension - repaglinide-irbesartan interaction

DiabetesDose recommendationNew interaction

Br J Clin Pharmacol 2026· AugRead

Functional Clopidogrel Resistance and CYP2C19 Genetic Determinants After Lower Limb Endovascular Intervention: A Systematic Review and Meta-analysis of Clinically Relevant Outcomes.

Peripheral arterial disease - clopidogrel resistance

CardiologyCPIC Level AAdverse reaction

Clin Ther 2026· AugRead

Pre-emptive PGx

Model-based clinical utility of pharmacogenetic testing and its potential population impact on the use of essential medicines in Zimbabwe.

Pharmacogenetic implementation in sub-Saharan Africa

Preemptive genotyping

Front Pharmacol 2026· AugRead

References and sources

CYP2C19 — Ischemic stroke — genotype-guided antiplatelet therapy. Front Neurol 2026. PMID 42591290. Score 8/10. https://pubmed.ncbi.nlm.nih.gov/42591290/
CYP2D6 — Postoperative pain - tramadol-opioid combination. Clin Pharmacol Ther 2026. PMID 42605662. Score 8/10. https://pubmed.ncbi.nlm.nih.gov/42605662/
Tacrolimus dose individualization in organ transplantation. CPT Pharmacometrics Syst Pharmacol 2026. PMID 42587384. Score 7/10. https://ascpt.onlinelibrary.wiley.com/doi/10.1002/psp4.70315?af=R
DPYD — Dihydropyrimidine dehydrogenase deficiency and fluoropyrimidine toxicity. Br J Clin Pharmacol 2026. PMID 42596594. Score 7/10. https://pubmed.ncbi.nlm.nih.gov/42596594/
Depression — antidepressant treatment trajectories and polygenic scores. medRxiv 2026. doi:10.64898/2026.08.14.26360458. Score 7/10. https://www.medrxiv.org/content/10.64898/2026.08.14.26360458v1
Pre-emptive pharmacogenomic testing in primary care. medRxiv 2026. doi:10.64898/2026.08.11.26360205. Score 6/10. https://www.medrxiv.org/content/10.64898/2026.08.11.26360205v1
SLCO1B1 — Type 2 diabetes and hypertension - repaglinide-irbesartan interaction. Br J Clin Pharmacol 2026. PMID 42595332. Score 6/10. https://pubmed.ncbi.nlm.nih.gov/42595332/
CYP2C19 — Peripheral arterial disease - clopidogrel resistance. Clin Ther 2026. PMID 42586868. Score 6/10. https://pubmed.ncbi.nlm.nih.gov/42586868/
Pharmacogenetic implementation in sub-Saharan Africa. Front Pharmacol 2026. PMID 42602164. Score 5/10. https://pubmed.ncbi.nlm.nih.gov/42602164/