GeneRx — Pharmacogenetic database
GeneRx is a pharmacogenetic database covering approx. 200 different drug substances which have been found to be affected by the genetic variation in enzyme metabolic rates. Pharmacogenetic tests allow physicians to select the right drugs with the right dosage according to the patient's individual genotype. GeneRx helps the physician to identify the cases, in which genetic testing is recommended, and gives clear instructions on how to interpret the genetic test results.
Database contents:
- Active ingredient, ATC code(s), generic drug name
- Genetic variations related to the drug
- Information about the phenotype affected, e.g. metabolic rate
- Recommendation texts, e.g. dosing recommendations
- References
- Available genetic tests and their indications
- Genetic test providers, contact information and ordering instructions
Database selection criteria
Abomics GeneRx Database is a collection of recommendations for the most clinically relevant and actionable pharmacogenetic drug-gene pairs. The contents of the database reflect, to some extent, published expert opinions, pharmacogenetic recommendations and contents of commercial pharmacogenetic test panels. Clinical actionability of certain known drug-gene pairs is less obvious due to insufficient scientific evidence. Various pharmacogenetic test panels include many genes with a lot of published variations but with controversial or unrepeated results. As the database is intended to be directly implemented in clinical use, the included genes are primarily those which have drug recommendations with sufficient scientific evidence and high clinical relevance. The database is neither fully exclusive nor inclusive, and is subject to change as new literature is published.
Update protocols
We at Abomics continuously follow the research and publishing related to pharmacogenetics. Based on the assessments of our experts, we regularly update the the database several times every year. Newly published literature for each gene-drug pair is reviewed, and recommendations are updated when needed. New genes and drugs for existing genes are also included on every update cycle.
Recommendations are mostly based on published expert opinions and articles on pharmacogenetic recommendation, e.g. by the Clinical Pharmacogenetics Implementation Consortium (CPIC). Abomics medical advisors also review the literature published after the publication of these major articles, and the recommendations may be modified if new information warrants this. The FDA’s list of pharmacogenetic biomarkers in drug labels is also taken into consideration in the update process. Recommendations are thus based on published, citable articles and drug labels or SPC (summary of product characteristics) documents but reflect the synthesis of information gathered by Abomics’ medical advisors. The clinical decision-making for drug dosing for each patient is, however, on the treating physician’s responsibility.
Clinical significance
| A | Pharmacogenetic variation does not significantly affect drug effectiveness or adverse reactions. |
| B | Pharmacogenetic variation may affect drug effectiveness or adverse reactions, but with minor clinical significance in most patients. Monitor drug response and possible adverse reactions. If genetic test results are available, consider changing drug or dosing based on results. |
| C | Pharmacogenetic variation affects drug effectiveness or adverse reactions with some clinical relevance. If genetic test results are available, consider changing drug or dosing based on results. If genetic testing has not been conducted, consider ordering a test. |
| D | Pharmacogenetic variation affects drug effectiveness or adverse reactions with significant clinical relevance. A genetic test is recommended. Check existing test results before prescribing the drug. Check dosing and administration based on test results. |
Level of evidence
| 0 | Level of evidence not defined. |
| 1 | Published incomplete case reports or product information, or deduction based on studies with similar drugs. |
| 2 | Published case reports, well documented. |
| 3 | Published controlled studies. |
| 4 | Published controlled studies of good quality. |
