Pharmacogenomics Implementation at the National Institutes of Health Clinical Center

Tristan M. Sissung, Jon W. McKeeby, Jharana Patel, Juan J. Lertora, Parag Kumar, Willy A. Flegel, Sharon D. Adams, Ellen J. Eckes, Frank Mickey, Teri M. Plona, Stephanie D. Mellot, Ryan N. Baugher, Xiaolin Wu, Daniel R. Soppet, Mary E. Barcus, Vivekananda Datta, Kristen M. Pike, Gary DiPatrizio, William D. Figg*, Barry R. Goldspiel

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

19 Scopus citations

Abstract

The National Institutes of Health Clinical Center (NIH CC) is the largest hospital in the United States devoted entirely to clinical research, with a highly diverse spectrum of patients. Patient safety and clinical quality are major goals of the hospital, and therapy is often complicated by multiple cotherapies and comorbidities. To this end, we implemented a pharmacogenomics program in 2 phases. In the first phase, we implemented genotyping for HLA-A and HLA-B gene variations with clinical decision support (CDS) for abacavir, carbamazepine, and allopurinol. In the second phase, we implemented genotyping for drug-metabolizing enzymes and transporters: SLCO1B1 for CDS of simvastatin and TPMT for CDS of mercaptopurine, azathioprine, and thioguanine. The purpose of this review is to describe the implementation process, which involves clinical, laboratory, informatics, and policy decisions pertinent to the NIH CC.

Original languageEnglish
Pages (from-to)S67-S77
JournalJournal of Clinical Pharmacology
Volume57
DOIs
StatePublished - 2017
Externally publishedYes

Keywords

  • implementation
  • pharmacogenomics
  • precision medicine
  • translation

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