2. Academic Validation
  3. Clinical Pharmacogenetics Implementation Consortium Guideline for CYP2C19 Genotype and Clopidogrel Therapy: 2022 Update

Clinical Pharmacogenetics Implementation Consortium Guideline for CYP2C19 Genotype and Clopidogrel Therapy: 2022 Update

  • Clin Pharmacol Ther. 2022 Nov;112(5):959-967. doi: 10.1002/cpt.2526.
Craig R Lee 1,  Jasmine A Luzum 2,  Katrin Sangkuhl 3,  Roseann S Gammal 4 5,  Marc S Sabatine 6,  Charles Michael Stein 7,  David F Kisor 8,  Nita A Limdi 9,  Yee Ming Lee 10,  Stuart A Scott 11 12,  Jean-Sébastien Hulot 13,  Dan M Roden 14,  Andrea Gaedigk 15,  Kelly E Caudle 5,  Teri E Klein 3,  Julie A Johnson 16,  Alan R Shuldiner 17
Affiliations

Affiliations

  • 1 Division of Pharmacotherapy and Experimental Therapeutics, University of North Carolina Eshelman School of Pharmacy, Chapel Hill, North Carolina, USA.
  • 2 Department of Clinical Pharmacy, University of Michigan College of Pharmacy, Ann Arbor, Michigan, USA.
  • 3 Department of Biomedical Data Science, Stanford University, Stanford, California, USA.
  • 4 Department of Pharmacy Practice, Massachusetts College of Pharmacy and Health Sciences, Boston, Massachusetts, USA.
  • 5 Department of Pharmacy and Pharmaceutical Sciences, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
  • 6 Thrombolysis in Myocardial Infarction Study Group, Cardiovascular Division, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA.
  • 7 Division of Clinical Pharmacology, Departments of Medicine and Pharmacology, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
  • 8 Department of Pharmaceutical Sciences, Manchester University, Fort Wayne, Indiana, USA.
  • 9 Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, USA.
  • 10 Department of Clinical Pharmacy, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado, USA.
  • 11 Department of Pathology, Stanford University, Stanford, California, USA.
  • 12 Clinical Genomics Laboratory, Stanford Health Care, Palo Alto, California, USA.
  • 13 Université de Paris, CIC1418 and DMU CARTE, AP-HP, Hôpital Européen Georges-Pompidou, Paris, France.
  • 14 Departments of Medicine and Pharmacology, Office of Personalized Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
  • 15 Division of Clinical Pharmacology, Toxicology & Therapeutic Innovation, Children's Mercy Kansas City and University of Missouri Kansas City School of Medicine, Kansas City, Missouri, USA.
  • 16 Department of Pharmacotherapy and Translational Research, Center for Pharmacogenomics and Precision Medicine, College of Pharmacy, University of Florida, Gainesville, Florida, USA.
  • 17 Department of Medicine, and Program for Genomic and Personalized Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA.
PMID: 35034351 DOI: 10.1002/cpt.2526
Abstract

CYP2C19 catalyzes the bioactivation of the antiplatelet prodrug clopidogrel, and CYP2C19 genotype impacts clopidogrel active metabolite formation. CYP2C19 intermediate and poor metabolizers who receive clopidogrel experience reduced platelet inhibition and increased risk for major adverse cardiovascular and cerebrovascular events. This guideline is an update to the 2013 Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline for the use of clopidogrel based on CYP2C19 genotype and includes expanded indications for CYP2C19 genotype-guided antiplatelet therapy, increased strength of recommendation for CYP2C19 intermediate metabolizers, updated CYP2C19 genotype to phenotype translation, and evidence from an expanded literature review (updates at www.cpicpgx.org).

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