{"id":15299,"date":"2023-04-04T14:53:11","date_gmt":"2023-04-04T13:53:11","guid":{"rendered":"https:\/\/www.heartgenetics.com\/?page_id=15299"},"modified":"2024-10-07T16:49:25","modified_gmt":"2024-10-07T15:49:25","slug":"s-clopidogrel-pharmacogenetics","status":"publish","type":"page","link":"https:\/\/www.heartgenetics.com\/pt\/especialistas\/farmacogenomica\/s-clopidogrel-pharmacogenetics\/","title":{"rendered":"Clopidogrel PGx"},"content":{"rendered":"<h2 class=\"wp-block-heading\">Clopidogrel<\/h2><p>Clopidogrel is a drug used worldwide as an antiplatelet agent in the treatment and prevention of atherothrombotic events. Being a prodrug, clopidogrel needs hepatic bioactivation into an active form (Clo-AM) in order to inhibit platelet aggregation. <\/p><p>If not properly metabolized, clopidogrel may cause severe adverse cardiovascular effects due to non-optimal drug dose.<\/p><div class=\"wp-block-kobu-custom-blocks-responsive-spacer responsive-spacer size-large\"><\/div><h2 class=\"wp-block-heading\">Clopidogrel Pharmacogenetics<\/h2><p><strong>CYP2C19<\/strong> is an important hepatic drug-metabolizing enzyme and is responsible for the metabolic activation of clopidogrel. Considering the pharmacogenetics of clopidogrel, genetic variants in <strong>CYP2C19<\/strong> are known to impair the metabolism of this drug. Loss-of-function polymorphisms affect platelet inhibition by decreasing Clop-Am levels, resulting in an increased risk of recurrence of major adverse cardiovascular events.<\/p><div class=\"wp-block-kobu-custom-blocks-responsive-spacer responsive-spacer size-medium\"><\/div><h3 class=\"wp-block-heading\">Benefits of genetic testing<\/h3><p>By evaluating <strong>CYP2C19<\/strong>&nbsp; genetic variants it is possible to:<\/p><ul class=\"wp-block-list\"><li>evaluate the patient response to clopidogrel<\/li><li>prescribe an adequate dose<\/li><li>define alternative antiplatelet therapy<\/li><li>avoid adverse cardiovascular effects<\/li><\/ul><div class=\"wp-block-kobu-custom-blocks-responsive-spacer responsive-spacer size-large\"><\/div><h2 class=\"wp-block-heading\">Genetic Panel<\/h2><p>The genetic test evaluates 3 genetic variants in the <strong>CYP2C19<\/strong> gene (9 haplotypes ) that are associated with clopidogrel\u2019s pharmacokinetics. The polymorphisms can either increase (gain-of-function alleles) or decrease (loss-of-function alleles) the catalytic activity of <strong>CYP2C19<\/strong> enzyme resulting in phenotypes that affect clopidogrel metabolism and consequent platelet inhibition.<\/p><div class=\"wp-block-kobu-custom-blocks-responsive-spacer responsive-spacer size-medium\"><\/div><div class=\"accordion \">\n            <dl id=\"accordion-group-accordion-group-69e66babca7ab\" role=\"presentation\">\n                                <dt aria-level=\"3\" class=\" open\" data-index=\"0\">\n                        <button aria-expanded=\"true\" class=\"accordion-trigger\" aria-controls=\"accordion-content0-accordion-group-69e66babca7ab\" id=\"accordion-trigger0-accordion-group-69e66babca7ab\" type=\"button\">\n                            <span class=\"accordion-title\">CYP2C19<\/span>\n                        <\/button>\n                    <\/dt>\n                    <dd id=\"accordion-content0-accordion-group-69e66babca7ab\" aria-labelledby=\"accordion-trigger0-accordion-group-69e66babca7ab\" class=\"accordion-panel\" style=\"display: block;\">\n                        <div class=\"accordion-content\">\n                            <p>u003cspan style=u0022font-weight: 400;u0022u003eCytochrome P450, Family 2, Subfamily C, Polypeptide 19, is a member of the cytochrome P450 superfamily with a significant action in clopidogrel metabolismu003c\/spanu003e<\/p>\n                        <\/div>\n                    <\/dd>\n                    <\/dl>\n    <\/div><div class=\"wp-block-kobu-custom-blocks-responsive-spacer responsive-spacer size-large\"><\/div><h2 class=\"wp-block-heading\">International Guidelines AND DRUG LABEL ANNOTATIONS<\/h2><p>Genetic testing is recommended by several renowned international organizations, such as the Food and Drug Administration (FDA) and the Clinical Pharmacogenetics Implementation Consortium (CPIC)<\/p><p>The FDA warns that patients who do not efficiently metabolize clopidogrel are at increased cardiovascular risk and therefore indicate that, when possible, the presence of non-functional <strong>CYP2C19<\/strong> alleles should be tested. In these cases, it recommends that healthcare professionals consider the use of other antiplatelet drugs.<\/p><p>The Clinical Pharmacogenetics Implementation Consortium (CPIC) that develops peer-reviewed gene-drug guidelines based on new developments in the field, has established several recommendations on alternative antiplatelet therapy based on <strong>CYP2C19<\/strong> genotype.<\/p><div class=\"wp-block-kobu-custom-blocks-responsive-spacer responsive-spacer size-large\"><\/div><div class=\"wp-block-kobu-custom-blocks-section-wrapper alignfull kobu-section has-background has-quinary-background-color\"><div class=\"wp-block-kobu-custom-blocks-responsive-spacer responsive-spacer size-large\"><\/div>\n\n<div class=\"wp-block-columns two-columns-icon-left is-layout-flex wp-container-core-columns-is-layout-1 wp-block-columns-is-layout-flex\"><div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\"><noscript class=\"loading-lazy\"><figure class=\"wp-block-image size-full is-resized\"><a href=\"https:\/\/www.heartgenetics.com\/files\/uploads\/2022\/05\/heartgenetics-turnaroundtime-icon.png\"><img loading=\"lazy\" decoding=\"async\" src=\"https:\/\/www.heartgenetics.com\/files\/uploads\/2022\/05\/heartgenetics-turnaroundtime-icon.png\" alt=\"10 days Turn around time\" class=\"wp-image-12512\" width=\"108\" height=\"108\" srcset=\"https:\/\/www.heartgenetics.com\/files\/uploads\/2022\/05\/heartgenetics-turnaroundtime-icon.png 300w, https:\/\/www.heartgenetics.com\/files\/uploads\/2022\/05\/heartgenetics-turnaroundtime-icon-150x150.png 150w, https:\/\/www.heartgenetics.com\/files\/uploads\/2022\/05\/heartgenetics-turnaroundtime-icon-100x100.png 100w\" sizes=\"auto, (max-width: 108px) 100vw, 108px\" \/><\/a><\/figure><\/noscript><\/div>\n\n<div class=\"wp-block-column is-layout-flow wp-block-column-is-layout-flow\"><h2 class=\"has-large-font-size wp-block-heading\">Turnaround time<\/h2>\n\n<p>10 working days<\/p>\n\n<div style=\"height:20px\" aria-hidden=\"true\" class=\"wp-block-spacer\"><\/div>\n\n<div class=\"wp-block-buttons is-layout-flex wp-block-buttons-is-layout-flex\"><div class=\"wp-block-button\"><a class=\"wp-block-button__link\" href=\"https:\/\/www.heartgenetics.com\/contacts\/\">Click here to contact sales<\/a><\/div><\/div><\/div><\/div>\n\n<div class=\"wp-block-kobu-custom-blocks-responsive-spacer responsive-spacer size-large\"><\/div><\/div><div class=\"wp-block-kobu-custom-blocks-responsive-spacer responsive-spacer size-large\"><\/div><h2 class=\"wp-block-heading\">Scientific Studies<\/h2><div class=\"wp-block-group is-layout-flow wp-block-group-is-layout-flow\">[1] Angiolillo et al., Journal of the American College of Cardiology 49, 1505\u20131516 (2007)<br>[2] Holmes et al., JAMA 306, 2704\u20132714 (2011)<br>[3] Mega et al., The New England Journal of Medicine 360, 354\u2013362 (2009)<br>[4] Scott et al., Clinical Pharmacology and Therapeutics 94, 317\u2013323 (2013)<\/p><\/div>","protected":false},"excerpt":{"rendered":"<p>Clopidogrel Clopidogrel is a drug used worldwide as an antiplatelet agent in the treatment and prevention of atherothrombotic events. Being a prodrug, clopidogrel needs hepatic [&hellip;]<\/p>\n","protected":false},"author":254,"featured_media":12168,"parent":12671,"menu_order":170,"comment_status":"closed","ping_status":"closed","template":"templates\/mygenes.php","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-15299","page","type-page","status-publish","has-post-thumbnail","hentry"],"acf":[],"aioseo_notices":[],"_links":{"self":[{"href":"https:\/\/www.heartgenetics.com\/pt\/wp-json\/wp\/v2\/pages\/15299","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.heartgenetics.com\/pt\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.heartgenetics.com\/pt\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.heartgenetics.com\/pt\/wp-json\/wp\/v2\/users\/254"}],"replies":[{"embeddable":true,"href":"https:\/\/www.heartgenetics.com\/pt\/wp-json\/wp\/v2\/comments?post=15299"}],"version-history":[{"count":7,"href":"https:\/\/www.heartgenetics.com\/pt\/wp-json\/wp\/v2\/pages\/15299\/revisions"}],"predecessor-version":[{"id":15753,"href":"https:\/\/www.heartgenetics.com\/pt\/wp-json\/wp\/v2\/pages\/15299\/revisions\/15753"}],"up":[{"embeddable":true,"href":"https:\/\/www.heartgenetics.com\/pt\/wp-json\/wp\/v2\/pages\/12671"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.heartgenetics.com\/pt\/wp-json\/wp\/v2\/media\/12168"}],"wp:attachment":[{"href":"https:\/\/www.heartgenetics.com\/pt\/wp-json\/wp\/v2\/media?parent=15299"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}