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Pharmacogenomics
Week of 20 October 2026
5 articles
Geno'X Veille — genox-veille.fr
Key takeaways this week
- ►CYP2D6 — negative randomized trial: genotype-guided opioid prescribing improved neither pain at 3 months (-0.8 vs. -0.7) nor drug-gene concordance (26.8% vs. 27.1%) in 282 carriers of an actionable phenotype.
- ►YEATS4 / NAT2 — GUARDD-US: immediate return of pharmacogenetic results did not change systolic blood pressure at 3 months (-0.3 mm Hg), with a gain confined to the 867 carriers of an actionable YEATS4 genotype (-2.46 mm Hg).
- ►CYP2D6 — in 44,485 All of Us metoprolol users, metabolizer phenotype shifted heart rate (-1.85 bpm in poor metabolizers) and bradycardia (odds ratio 1.19) but not treatment discontinuation.
- ►CYP2C19 — in 2,818 escitalopram-treated patients, the metabolic ratio gap between ultrarapid and poor metabolizers fell from 4.5-fold without proton pump inhibitors to 2.8-fold on pantoprazole and 1.8-fold on esomeprazole/omeprazole.
- ►DPYD / UGT1A1 — severe adverse events in 12.5% vs. 50.7% with genotype-guided treatment (odds ratio 0.15), in 16 guided patients matched to 75 controls.
5 articles of 5
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CYP2D6
PubMedCYP2D6-Guided Opioid Therapy for Chronic Pain: A Multi-Center Pragmatic Randomized Controlled Trial.
Chronic pain treated with opioids
8
Preemptive genotypingAdverse reaction
Clin Pharmacol Ther 2026· OctRead
NAT2, YEATS4
PubMedA Pilot Randomized Study of NAT2 and YEATS4 Pharmacogenetic Return of Results in Adults with Hypertension and African Ancestry: The GUARDD-US PGx Study.
Adult arterial hypertension
8
Preemptive genotypingDose recommendation
Clin Pharmacol Ther 2026· OctRead
CYP2C19
PubMedReprocessing Mass Spectra from Therapeutic Drug Monitoring to Unveil Proton Pump Inhibitor Use and Quantify Phenoconversion of Escitalopram Metabolism in CYP2C19-Genotyped Patients.
Depression treated with escitalopram
7
PhenoconversionNew interaction
Clin Pharmacol Ther 2026· OctRead
CYP2D6
PubMedCytochrome P450 2D6 Metabolizer Phenotype Is Associated With Metoprolol Pharmacodynamics But Not With Metoprolol Discontinuation: A Retrospective Cohort Study in the All of Us Research Program.
Metoprolol therapy
6
Adverse reactionPhenoconversion
J Clin Med Res 2026· SepRead
DPYD, UGT1A1
PubMedReal-world analysis of genotype-guided treatment for carriers of actionable DPYD and UGT1A1 variants.
Fluoropyrimidine or irinotecan chemotherapy
6
OncologyDose recommendationAdverse reaction
Pharmacogenomics J 2026· OctRead
References and sources
- CYP2D6 — Chronic pain treated with opioids. Clin Pharmacol Ther 2026. PMID 42878248. Score 8/10. https://pubmed.ncbi.nlm.nih.gov/42878248/
- NAT2, YEATS4 — Adult arterial hypertension. Clin Pharmacol Ther 2026. PMID 42894271. Score 8/10. https://pubmed.ncbi.nlm.nih.gov/42894271/
- CYP2D6 — Metoprolol therapy. J Clin Med Res 2026. PMID 42872278. Score 6/10. https://pubmed.ncbi.nlm.nih.gov/42872278/
- CYP2C19 — Depression treated with escitalopram. Clin Pharmacol Ther 2026. PMID 42876187. Score 7/10. https://pubmed.ncbi.nlm.nih.gov/42876187/
- DPYD, UGT1A1 — Fluoropyrimidine or irinotecan chemotherapy. Pharmacogenomics J 2026. PMID 42864318. Score 6/10. https://pubmed.ncbi.nlm.nih.gov/42864318/