Prevalence of CYP2C19*2 carriers in Saudi ischemic stroke patients and the suitability of using genotyping to guide antiplatelet therapy in a university hospital setup

Abdullah M Al-Rubaish; Fahad A Al-Muhanna; Abdullah M Alshehri; Abdulla A Alsulaiman; Majed M Alabdulali; Fahad Alkhamis; Abdulallh S Alamri; Rudaynah A Alali; Mohammed S Akhtar; Cyril Cyrus; Daniel M F Claassens; Folkert W Asselbergs; Amein K Al-Ali

doi:https://doi.org/10.1515/dmpt-2021-0104

Prevalence of CYP2C19*2 carriers in Saudi ischemic stroke patients and the suitability of using genotyping to guide antiplatelet therapy in a university hospital setup

Abdullah M Al-Rubaish, Fahad A Al-Muhanna, Abdullah M Alshehri, Abdulla A Alsulaiman, Majed M Alabdulali, Fahad Alkhamis, Abdulallh S Alamri, Rudaynah A Alali, Mohammed S Akhtar, Cyril Cyrus, Daniel M F Claassens, Folkert W Asselbergs, Amein K Al-Ali

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

OBJECTIVES: To mitigate the incidence of recurrent stroke in patients, dual antiplatelet therapy comprising aspirin and clopidogrel is usually administered. Clopidogrel is a prodrug and its bioactivation is catalyzed by cytochrome P450 (CYP)2C19. The main objective of this work was to determine the prevalence of CYP2C19*2 carriers in Saudi ischemic stroke patients and assess the suitability of using genotyping to guide antiplatelet therapy in a university hospital setup.

METHODS: This prospective (2018-2019) study was conducted on 256 patients (age 61 ± 12.5) clinically diagnosed with ischemic stroke who were genotyped using Spartan RX CYP2C19 assay.

RESULTS: From the total patient group (256), upon admission, 210 patients were prescribed either aspirin, clopidogrel or dual antiplatelet therapy. Of the 27 patients with the CYP2C19*2 allele who were prescribed clopidogrel (18) or dual antiplatelet therapy (9), only 21 patients could be followed up for a period of six months post stroke event, in addition to 21 age- and sex-matched patients with the normal allele. The CYP2C19*2 allele carriers had a statistically significant increased risk of recurrent stroke compared to patients carrying the normal allele.

CONCLUSIONS: This study shows the suitability of using genotyping to guide antiplatelet therapy in ischemic stroke patients in a clinical setting.

Original language	English
Pages (from-to)	35-40
Number of pages	6
Journal	Drug Metabolism and Personalized Therapy
Volume	37
Issue number	1
DOIs	https://doi.org/10.1515/dmpt-2021-0104
Publication status	Published - 8 Jul 2021
Externally published	Yes

Keywords

Aged
Aspirin/therapeutic use
Clopidogrel/therapeutic use
Cytochrome P-450 CYP2C19/genetics
Genotype
Hospitals
Humans
Ischemic Stroke/drug therapy
Middle Aged
Platelet Aggregation Inhibitors/therapeutic use
Prevalence
Prospective Studies
Saudi Arabia/epidemiology

Access to Document

https://doi.org/10.1515/dmpt-2021-0104

Cite this

Al-Rubaish, A. M., Al-Muhanna, F. A., Alshehri, A. M., Alsulaiman, A. A., Alabdulali, M. M., Alkhamis, F., Alamri, A. S., Alali, R. A., Akhtar, M. S., Cyrus, C., Claassens, D. M. F., Asselbergs, F. W., & Al-Ali, A. K. (2021). Prevalence of CYP2C19*2 carriers in Saudi ischemic stroke patients and the suitability of using genotyping to guide antiplatelet therapy in a university hospital setup. Drug Metabolism and Personalized Therapy, 37(1), 35-40. https://doi.org/10.1515/dmpt-2021-0104

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title = "Prevalence of CYP2C19*2 carriers in Saudi ischemic stroke patients and the suitability of using genotyping to guide antiplatelet therapy in a university hospital setup",

abstract = "OBJECTIVES: To mitigate the incidence of recurrent stroke in patients, dual antiplatelet therapy comprising aspirin and clopidogrel is usually administered. Clopidogrel is a prodrug and its bioactivation is catalyzed by cytochrome P450 (CYP)2C19. The main objective of this work was to determine the prevalence of CYP2C19*2 carriers in Saudi ischemic stroke patients and assess the suitability of using genotyping to guide antiplatelet therapy in a university hospital setup.METHODS: This prospective (2018-2019) study was conducted on 256 patients (age 61 ± 12.5) clinically diagnosed with ischemic stroke who were genotyped using Spartan RX CYP2C19 assay.RESULTS: From the total patient group (256), upon admission, 210 patients were prescribed either aspirin, clopidogrel or dual antiplatelet therapy. Of the 27 patients with the CYP2C19*2 allele who were prescribed clopidogrel (18) or dual antiplatelet therapy (9), only 21 patients could be followed up for a period of six months post stroke event, in addition to 21 age- and sex-matched patients with the normal allele. The CYP2C19*2 allele carriers had a statistically significant increased risk of recurrent stroke compared to patients carrying the normal allele.CONCLUSIONS: This study shows the suitability of using genotyping to guide antiplatelet therapy in ischemic stroke patients in a clinical setting.",

keywords = "Aged, Aspirin/therapeutic use, Clopidogrel/therapeutic use, Cytochrome P-450 CYP2C19/genetics, Genotype, Hospitals, Humans, Ischemic Stroke/drug therapy, Middle Aged, Platelet Aggregation Inhibitors/therapeutic use, Prevalence, Prospective Studies, Saudi Arabia/epidemiology",

author = "Al-Rubaish, {Abdullah M} and Al-Muhanna, {Fahad A} and Alshehri, {Abdullah M} and Alsulaiman, {Abdulla A} and Alabdulali, {Majed M} and Fahad Alkhamis and Alamri, {Abdulallh S} and Alali, {Rudaynah A} and Akhtar, {Mohammed S} and Cyril Cyrus and Claassens, {Daniel M F} and Asselbergs, {Folkert W} and Al-Ali, {Amein K}",

note = "{\textcopyright} 2021 Walter de Gruyter GmbH, Berlin/Boston.",

year = "2021",

month = jul,

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doi = "https://doi.org/10.1515/dmpt-2021-0104",

language = "English",

volume = "37",

pages = "35--40",

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Al-Rubaish, AM, Al-Muhanna, FA, Alshehri, AM, Alsulaiman, AA, Alabdulali, MM, Alkhamis, F, Alamri, AS, Alali, RA, Akhtar, MS, Cyrus, C, Claassens, DMF, Asselbergs, FW & Al-Ali, AK 2021, 'Prevalence of CYP2C19*2 carriers in Saudi ischemic stroke patients and the suitability of using genotyping to guide antiplatelet therapy in a university hospital setup', Drug Metabolism and Personalized Therapy, vol. 37, no. 1, pp. 35-40. https://doi.org/10.1515/dmpt-2021-0104

Prevalence of CYP2C19*2 carriers in Saudi ischemic stroke patients and the suitability of using genotyping to guide antiplatelet therapy in a university hospital setup. / Al-Rubaish, Abdullah M; Al-Muhanna, Fahad A; Alshehri, Abdullah M et al.
In: Drug Metabolism and Personalized Therapy, Vol. 37, No. 1, 08.07.2021, p. 35-40.

Research output: Contribution to journal › Article › Academic › peer-review

TY - JOUR

T1 - Prevalence of CYP2C19*2 carriers in Saudi ischemic stroke patients and the suitability of using genotyping to guide antiplatelet therapy in a university hospital setup

AU - Al-Rubaish, Abdullah M

AU - Al-Muhanna, Fahad A

AU - Alshehri, Abdullah M

AU - Alsulaiman, Abdulla A

AU - Alabdulali, Majed M

AU - Alkhamis, Fahad

AU - Alamri, Abdulallh S

AU - Alali, Rudaynah A

AU - Akhtar, Mohammed S

AU - Cyrus, Cyril

AU - Claassens, Daniel M F

AU - Asselbergs, Folkert W

AU - Al-Ali, Amein K

PY - 2021/7/8

Y1 - 2021/7/8

N2 - OBJECTIVES: To mitigate the incidence of recurrent stroke in patients, dual antiplatelet therapy comprising aspirin and clopidogrel is usually administered. Clopidogrel is a prodrug and its bioactivation is catalyzed by cytochrome P450 (CYP)2C19. The main objective of this work was to determine the prevalence of CYP2C19*2 carriers in Saudi ischemic stroke patients and assess the suitability of using genotyping to guide antiplatelet therapy in a university hospital setup.METHODS: This prospective (2018-2019) study was conducted on 256 patients (age 61 ± 12.5) clinically diagnosed with ischemic stroke who were genotyped using Spartan RX CYP2C19 assay.RESULTS: From the total patient group (256), upon admission, 210 patients were prescribed either aspirin, clopidogrel or dual antiplatelet therapy. Of the 27 patients with the CYP2C19*2 allele who were prescribed clopidogrel (18) or dual antiplatelet therapy (9), only 21 patients could be followed up for a period of six months post stroke event, in addition to 21 age- and sex-matched patients with the normal allele. The CYP2C19*2 allele carriers had a statistically significant increased risk of recurrent stroke compared to patients carrying the normal allele.CONCLUSIONS: This study shows the suitability of using genotyping to guide antiplatelet therapy in ischemic stroke patients in a clinical setting.

AB - OBJECTIVES: To mitigate the incidence of recurrent stroke in patients, dual antiplatelet therapy comprising aspirin and clopidogrel is usually administered. Clopidogrel is a prodrug and its bioactivation is catalyzed by cytochrome P450 (CYP)2C19. The main objective of this work was to determine the prevalence of CYP2C19*2 carriers in Saudi ischemic stroke patients and assess the suitability of using genotyping to guide antiplatelet therapy in a university hospital setup.METHODS: This prospective (2018-2019) study was conducted on 256 patients (age 61 ± 12.5) clinically diagnosed with ischemic stroke who were genotyped using Spartan RX CYP2C19 assay.RESULTS: From the total patient group (256), upon admission, 210 patients were prescribed either aspirin, clopidogrel or dual antiplatelet therapy. Of the 27 patients with the CYP2C19*2 allele who were prescribed clopidogrel (18) or dual antiplatelet therapy (9), only 21 patients could be followed up for a period of six months post stroke event, in addition to 21 age- and sex-matched patients with the normal allele. The CYP2C19*2 allele carriers had a statistically significant increased risk of recurrent stroke compared to patients carrying the normal allele.CONCLUSIONS: This study shows the suitability of using genotyping to guide antiplatelet therapy in ischemic stroke patients in a clinical setting.

KW - Aged

KW - Aspirin/therapeutic use

KW - Clopidogrel/therapeutic use

KW - Cytochrome P-450 CYP2C19/genetics

KW - Genotype

KW - Hospitals

KW - Humans

KW - Ischemic Stroke/drug therapy

KW - Middle Aged

KW - Platelet Aggregation Inhibitors/therapeutic use

KW - Prevalence

KW - Prospective Studies

KW - Saudi Arabia/epidemiology

U2 - https://doi.org/10.1515/dmpt-2021-0104

DO - https://doi.org/10.1515/dmpt-2021-0104

M3 - Article

C2 - 35385889

SN - 2363-8907

VL - 37

SP - 35

EP - 40

JO - Drug Metabolism and Personalized Therapy

JF - Drug Metabolism and Personalized Therapy

IS - 1

ER -