Clopidogrel, Stroke Prevention & Pharmacogenomics

Pharmacogenomics Education
Written By Coco Bates

The Problem with Clopidogrel

  • Clopidogrel is one of the most commonly prescribed medications for stroke & heart attack prevention in the UK.

  • Studies of European populations show that 32% of individuals have genetic variants that prevent Clopidogrel from working.

  • In British South Asian individuals, this rises to 57%.

  • People in the study with two loss-of-function CYP2C19 variants were more than three times more likely to have recurrent heart attacks.

  • More than two in three British South Asians in the study who had had a heart attack received clopidogrel.

  • Currently, prescribing medications often involves a trial-and-error approach.

Benefits of Pharmacogenomics (PGx) Testing for Clopidogrel

  • Reduces prescription guesswork by providing insights into an individual's genetic profile.

  • Pharmacogenomic testing can identify individuals who are poor metabolisers of CYP2C19.

  • Clopidogrel is activated in the liver by enzymes called CYP2C19, but in some cases, genetic differences mean this won’t happen properly.

  • These individuals are less likely to benefit from clopidogrel because they cannot effectively activate the drug.

  • PGx testing can help healthcare professionals choose the drugs and doses that are most likely to work for each individual patient.

  • By selecting the most appropriate medication, tailored to each patient's genetic predisposition from the outset, testing can ultimately reduce the risk of recurrent heart attacks.

The Side Effects of Clopidogrel and How PGx Testing Can Help

Like all medications, clopidogrel can cause side effects. These can include:

  • Bleeding

  • Bruising

  • Diarrhoea

  • Headaches

  • Stomach pains

  • Indigestion & others

However, Pharmacogenomic testing can help reduce the risk of these side effects by identifying individuals who are less likely to respond to clopidogrel.

PGx testing can help ensure that these individuals are prescribed alternative medications that may have fewer side effects.

The Future of PGx Testing and Clopidogrel

The future of PGx testing and clopidogrel is promising. The National Institute for Health and Care Excellence (NICE) in England and Wales is currently developing guidelines on CYP2C19 genotype testing to guide clopidogrel use after ischaemic stroke or transient ischaemic attack. These guidelines are expected to be published on 31 July 2024.

Conclusion

At Mantara, we understand the importance of personalised healthcare solutions. Our DNA affects how our bodies respond to medicine, if they’re effective, risk side effects, or require adjusted dosages.

Pharmacogenomic (PGx) testing allows healthcare professionals to write personalised prescriptions and determine optimal dosages based on an individual's DNA.

Your DNA Is Unique, So Why Isn’t Your Prescription?

Sources

Coco Bates
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