Pharmacogenetics of asthma: where are we now?

Center for Medical Genomics, Wake Forest University Baptist Medical Center, Medical Center Boulevard, Winston Salem, NC 27157, USA.
Clinics in Chest Medicine (Impact Factor: 2.07). 04/2006; 27(1):109-17, vii. DOI: 10.1016/j.ccm.2005.12.001
Source: PubMed


Pharmacogenetics adds value with improved clinical markers and increased ability to predict efficacy with greater clarity. This should lead to individualized and simplified dosing, improved efficacy with specific treatment, and enhanced safety. Improved patient response should lead to enhanced patient compliance. Many challenges remain ahead including ethical issues related to patient confidentiality and banking of DNA. Regulatory issues and guidelines need to be discussed to establish reasonable boundaries. There is also a need for review of diagnosis and treatment combinations and Food and Drug Administration review of the process. Legal issues including patents and commercial issues concerning patient, physician, and managed care acceptance must be addressed.

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    ABSTRACT: Both short-acting and long-acting β agonists have been used for many years for the treatment of asthma. Short-acting β agonists are life-saving and their role as rescue agents is unquestioned, but regular use is not recommended because of safety concerns and the effectiveness of asthma-controller medications. Long-acting β agonists are effective controller medications but have safety issues, so their use should be restricted to patients who are not optimally controlled on first-line controllers such as inhaled corticosteroids. The effect of the β receptor genotype on β agonist response is unclear but could hold promise for proper patient management.
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