Download leiden centre of excellence course in pharmacogenetics

EAHP INVENTORY OF GOOD PRACTICE INITIATIVES
EXAMPLE SUBMISSION 1
LEIDEN CENTRE OF EXCELLENCE COURSE IN PHARMACOGENETICS
1. In which country is the example you
would like to provide based in?
2. Please provide a title for the example of
a good practice initiative you are
providing
3. Please provide the name of the principal
hospital and/or region in which the good
practice initiative is based
4. Are you able to categorise the area/s of
practice from which your good practice
initiative is drawn?
5. Please provide a short introduction to
the example of a good practice initiative
in your country.
The Netherlands
Leiden Centre Of Excellence Course In
Pharmacogenetics
Leiden University Medical Center, Netherlands
Education
Pharmacotherapy (Pharmacogenetics)
Pharmacogenetics, promising the end of “one
size fits all” drugs and of trial and error in
pharmacotherapy, is often predicted to be one
of the first clinical applications in the
postgenomic era. Yet, while pharmacists are
often named as ideal candidates to translate the
new pharmacogenetic knowledge to clinical
practice many do not feel adequately informed
about the possibilities of genetic testing and its
applicability to their patients.
For this reason an excellence course in
pharmacogenetics is organised during three days
and can be attended by 15 clinical pharmacists
aiming to understand the basic concepts and
potential clinical applications of
pharmacogenetics to hospital pharmacy
practice.
Of Genes and Drugs
The first part of the course is hosted by the
department of Clinical Pharmacy &
Toxicology of the Leiden University Medical
Center. The course starts with an
introduction of the basic principles of genetics
and then proceeds to explain how
genetic variation may result in variability in drug
response. It is concluded that we
need pharmacogenetic tests in situations where
drug response cannot easily be assessed,
treatment delay results in severe consequences,
prognosis is poor or side effects are severe.
The potential of pharmacogenetics will be
illustrated by several drug-gene pairs
e.g. tamoxifen and CYP2D6, sunitinib and
CYP3A5, ABCB1 and NR1I3, 6mercaptopurine and TPMT, abacavir and HLAB*5701, simvastatin and SLCO1B1, and
irinotecan and UGT1A1.
In the afternoon of the First day the pros and
cons of the available pharmacogenetic assays are
discussed and participants will have the
opportunity to work with available techniques
(Taqman, Pyrosequencing, Amplichip, High
Resolution Melting).
The first day ends with a webinar demonstrating
of the resources available on the
Pharmacogenomics Knowledge Base
(www.pharmgkb.org) such as dosing guidelines
and drug labels, potentially clinically actionable
gene-drug associations and genotype-phenotype
relationships.
Clinical implementation
The second day focuses on the clinical
implementation of pharmacogenetics. Evidence
based pharmacogenetic guidelines created by
the Dutch Pharmacogenetics Working Group and
the Clinical Pharmacogenetics Implementation
Consortium will be presented.
Then, challenges for clinical implementation of
pharmacogenetics such as required level
of evidence and necessity of cost-effectiveness
analyses are discussed. Solid scientific
evidence for improvement in patient care is
required prior to implementing
pharmacogenetic testing.
Information on cost-effectiveness and costconsequences of pharmacogenetic tests will
facilitate implementation. In the afternoon
participants may obtain their own CYP2D6 and
CYP2C19 genotype using the Amplichip® test.
Clopidogrel as case study
The third day participants will focus on
implementing pharmacogenetics in their own
hospital. CYP2C19-clopidogrel is selected as
primary gene-drug pair to implement
because of the high level of scientific evidence, a
recommendation in the label to perform genetic
testing and the high number of patients treated
with this drug.
The course ends with a visit to the department
of clinical chemistry of the Erasmus
Medical Center. Participants are trained to
prepare dosing advices using guidelines
and pharmacogenetic websites.
Summary
6. Please provide the name of the primary
person that EAHP can contact for further
information about this good practice
initiative
7. Please provide the email address of the
primary person that EAHP can contact
about this example
8. Please provide the telephone number of
the primary person EAHP can contact
about this good practice initiative.
Although several gene-drug pairs have potential
for clinical implementation, the clinical
uptake of pharmacogenetics is still low. Centers
of excellence can play a role in
assisting clinical implementation of
pharmacogenetics by organizing
pharmacogenetic courses to increase
pharmacogenetic knowledge in the field and to
create a network of peers facilitating
implementation projects.
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