CPIC Guideline: CYP2C9 Genotyping for Safer NSAID Prescribing
This Clinical Pharmacogenetics Implementation Consortium guideline summarises the evidence linking CYP2C9 polymorphisms to altered NSAID metabolism and increased risk of gastrointestinal, renal, and cardiovascular adverse events. Therapeutic recommendations are provided for adjusting NSAID selection and dosing based on CYP2C9 genotype. Given the extremely high global usage of NSAIDs, this guideline has broad implications for preemptive pharmacogenomic testing panels in clinical laboratories.
The original study
Clinical Pharmacogenetics Implementation Consortium Guideline (CPIC) for CYP2C9 and Nonsteroidal Anti-Inflammatory Drugs.
- Authors
- Theken KN, Lee CR, Gong L, Caudle KE, Formea CM, Gaedigk A, et al.
- Journal
- Clinical pharmacology and therapeutics
- Type
- Journal Article, Practice Guideline, Research Support, N.I.H., Extramural
- PMID
- 32189324
Original abstract
Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most commonly used analgesics due to their lack of addictive potential. However, NSAIDs have the potential to cause serious gastrointestinal, renal, and cardiovascular adverse events. CYP2C9 polymorphisms influence metabolism and clearance of several drugs in this class, thereby affecting drug exposure and potentially safety. We summarize evidence from the published literature supporting these associations and provide therapeutic recommendations for NSAIDs based on CYP2C9 genotype (updates at www.cpicpgx.org).