Journal
EXPERT REVIEW OF NEUROTHERAPEUTICS
Volume 15, Issue 10, Pages 1161-1170Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1586/14737175.2015.1083424
Keywords
adverse drug reactions; antiepileptic drugs; efficacy; epilepsy; genetics; pharmacogenomics; pharmacoresistance
Categories
Funding
- EU
- Italian Medicines Agency
- Italian Ministry of Health
- Italian Ministry for Education, University and Research
- Biopharm Solutions
- Eisai
- GW Pharma
- Sun Pharma
- Takeda
- UCB Pharma
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Genetic factors contribute to the high interindividual variability in response to antiepileptic drugs. However, most genetic markers identified to date have limited sensitivity and specificity, and the value of genetic testing in guiding antiepileptic drug (AED) therapy is limited. The best defined indication for testing relates to HLA-B*15:02 genotyping to identify those individuals of South Asian ethnicity who are at high risk for developing serious adverse cutaneous reactions to carbamazepine. The indication for HLA-A*31:01 testing to identify individuals at risk for skin reactions from carbamazepine, or for CYP2C9 genotyping to identify individuals at risk for serious skin reactions from phenytoin is less compelling. The use of genetic testing to guide epilepsy treatment is likely to increase in the future, as better understanding of the function of epilepsy genes will permit the application of precision medicine targeting the biological mechanisms responsible for epilepsy in the specific individual.
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