Pharmacogenetics of cytochrome P450 and its applications in drug therapy: the past, present and future

The field of cytochrome P450 pharmacogenetics has progressed rapidly during the past 25 years. All the major human drug-metabolizing P450 enzymes have been identified and cloned, and the major gene variants that cause inter-individual variability in drug response and are related to adverse drug reactions have been identified. This information now provides the basis for the use of predictive pharmacogenetics to yield drug therapies that are more efficient and safer. Today, we understand which drugs warrant dosing based on pharmacogenetics to improve drug treatment. It is anticipated that, in the future, genotyping could be used to personalize drug treatment for vast numbers of subjects, decreasing the cost of drug treatment and increasing the efficacy of drugs and health in general. I estimate that such personalized P450 gene-based treatment would be relevant for 10-20% of all drug therapy.