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Pharmacogenomics
Week of 10 November 2026
7 articles
Geno'X Veille — genox-veille.fr
Key takeaways this week
- ►Pre-emptive genotyping — in Singapore, all 2,492 participants genotyped for 16 pharmacogenes carry at least one actionable variant, yet only 69 of 285 interruptive alerts (24.2%) change a prescription, and 17.3% for treatments already under way.
- ►SCN8A — among 173 individuals carrying 25 gain-of-function variants, those whose variant alters channel activation are seizure free in 20% of cases on sodium channel blockers, versus 69% for inactivation variants.
- ►CYP2C19 — in 1,352 genotyped patients switched to clopidogrel monotherapy after dual antiplatelet therapy, the 3-year composite outcome does not differ by metaboliser status (1.2% vs 2.2%).
- ►Psychiatric polypharmacy — in the PREPARE cohort, the pharmacogenomics-guided arm has half the hospitalisation risk in the presence of psychiatric polypharmacy (RR 0.49), through a change in drug choice rather than drug count.
- ►UGT1A1 — in 450 patients on irinotecan, poor metaboliser status multiplies the risk of grade 3 neutropenia by 4.36 around 107 mg/m², with no detectable effect around 80 mg/m².
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Genotype-guided drug prescribing across specialties
PubMedPre-emptive pharmacogenomics testing in clinical practice: A pilot implementation in Singapore
Genotype-guided drug prescribing across specialties
8
Preemptive genotyping
Br J Clin Pharmacol 2026· NovRead
SCN8A
PubMedDifferential effects of sodium channel blockers on SCN8A gain-of-function variants associated with drug-responsive or -resistant epilepsy
SCN8A-related epilepsies, from self-limited epilepsy to developmental and epileptic encephalopathy
7
New interactionRecurrent variant
Pharmacol Res 2026· SepRead
CYP2C19
PubMedGuided P2Y12 inhibitor selection after rapid CYP2C19 genotyping in patients undergoing percutaneous coronary intervention
Coronary artery disease treated by percutaneous intervention, dual antiplatelet therapy
6
CardiologyCPIC Level ADose recommendation
EuroIntervention 2026· NovRead
CYP2C19
PubMedPrognostic implication of CYP2C19 genotype during chronic clopidogrel monotherapy after percutaneous coronary intervention
Coronary artery disease after percutaneous intervention, long-term maintenance phase
6
CardiologyCPIC Level A
JACC Asia 2026· NovRead
UGT1A1
PubMedGene-dose interaction in low-dose irinotecan: a real-world cohort study of the association between adverse effects and UGT1A1 polymorphism
Irinotecan toxicity in patients treated for cancer
6
Adverse reactionDose recommendation
Pharmacotherapy 2026· NovRead
Psychiatry
PubMedPharmacogenomics positively impacts polypharmacy-related toxicity and clinical outcomes in psychiatric patients
Polypharmacy and adverse drug reactions in psychiatric patients
6
PsychiatryPreemptive genotypingAdverse reaction
Pharmacol Res 2026· NovRead
CYP2C19
PubMedGlobal distribution of CYP2C19 variants in clopidogrel-indicated populations: implications for pharmacogenomic-guided antiplatelet therapy
Populations indicated for clopidogrel antiplatelet therapy
6
CardiologyCPIC Level A
Pharmacogenomics 2026· NovRead
References and sources
- Genotype-guided drug prescribing across specialties. Br J Clin Pharmacol 2026. PMID 42989873. Score 8/10. https://pubmed.ncbi.nlm.nih.gov/42989873/
- SCN8A — SCN8A-related epilepsies, from self-limited epilepsy to developmental and epileptic encephalopathy. Pharmacol Res 2026. PMID 42800573. Score 7/10. https://pubmed.ncbi.nlm.nih.gov/42800573/
- CYP2C19 — Coronary artery disease treated by percutaneous intervention, dual antiplatelet therapy. EuroIntervention 2026. PMID 42975600. Score 6/10. https://pubmed.ncbi.nlm.nih.gov/42975600/
- CYP2C19 — Coronary artery disease after percutaneous intervention, long-term maintenance phase. JACC Asia 2026. PMID 42980239. Score 6/10. https://pubmed.ncbi.nlm.nih.gov/42980239/
- UGT1A1 — Irinotecan toxicity in patients treated for cancer. Pharmacotherapy 2026. PMID 43001636. Score 6/10. https://pubmed.ncbi.nlm.nih.gov/43001636/
- Polypharmacy and adverse drug reactions in psychiatric patients. Pharmacol Res 2026. PMID 42988188. Score 6/10. https://pubmed.ncbi.nlm.nih.gov/42988188/
- CYP2C19 — Populations indicated for clopidogrel antiplatelet therapy. Pharmacogenomics 2026. PMID 42973244. Score 6/10. https://pubmed.ncbi.nlm.nih.gov/42973244/