{"id":"cyp2c19-genotype-guided-dapt","safety":{"commonSideEffects":[{"rate":null,"effect":"Bleeding (major and minor)"},{"rate":null,"effect":"Stent thrombosis"},{"rate":null,"effect":"Recurrent myocardial infarction"}]},"_chembl":null,"_dailymed":null,"mechanism":{"_ai_source":"claude-haiku-4.5","explanation":"CYP2C19 is a cytochrome P450 enzyme critical for the metabolism of clopidogrel (Plavix), a commonly used antiplatelet agent. Patients with CYP2C19 loss-of-function variants have reduced conversion of clopidogrel to its active form, leading to diminished antiplatelet effects and increased risk of stent thrombosis or recurrent cardiovascular events. Genotype-guided DAPT uses CYP2C19 testing to identify poor metabolizers and either increase clopidogrel dose, switch to alternative P2Y12 inhibitors (prasugrel or ticagrelor) with less CYP2C19 dependence, or adjust therapy accordingly to optimize antiplatelet efficacy.","oneSentence":"This is a pharmacogenomic-guided dual antiplatelet therapy (DAPT) strategy that uses CYP2C19 genotyping to optimize antiplatelet drug selection and dosing for improved cardiovascular outcomes.","_ai_confidence":"medium"},"_scrapedAt":"2026-03-28T00:29:27.208Z","_scrapedBy":"cloudflare-swarm","_wikipedia":null,"indications":{"approved":[{"name":"Acute coronary syndrome (ACS) with percutaneous coronary intervention (PCI) and stent placement"},{"name":"Secondary prevention of stent thrombosis and recurrent cardiovascular events in CYP2C19 genotype-guided patient populations"}]},"trialDetails":[{"nctId":"NCT06665919","phase":"NA","title":"The Study of CYP2C19 Genotype-Guided Clopidogrel Treatment Models","status":"COMPLETED","sponsor":"Vistamedi Ltd.","startDate":"2023-06-15","conditions":"Coronary Artery Disease, Clopidogrel Resistance, Coronary Thrombosis","enrollment":283},{"nctId":"NCT06763744","phase":"PHASE4","title":"Genotype-Guided Abbreviated DAPT Versus Un-Guided De-escalation Therapy in Patients With ACS and HBR","status":"NOT_YET_RECRUITING","sponsor":"Samsung Medical Center","startDate":"2025-06-01","conditions":"Acute Coronary Syndrome (ACS) Undergoing Percutaneous Coronary Intervention (PCI), High Bleeding Risk","enrollment":3000},{"nctId":"NCT06943586","phase":"NA","title":"Pharmacogenomics in Stroke: Feasibility of CYP2C19 Testing","status":"RECRUITING","sponsor":"University of Alabama at Birmingham","startDate":"2025-04-09","conditions":"Stroke, Transient Ischemic Attack (TIA)","enrollment":200},{"nctId":"NCT06283888","phase":"PHASE4","title":"CYP2C19 Genotype-Guided P2Y12 Receptor Inhibitor Selection After Complex Percutaneous Coronary Intervention","status":"RECRUITING","sponsor":"Zunyi Medical College","startDate":"2024-04-01","conditions":"ACS - Acute Coronary Syndrome, CYP2C19 Polymorphism","enrollment":1200},{"nctId":"NCT05262803","phase":"PHASE4","title":"Reduced Antithrombotic Strategy for High Bleeding Risk Patients With Myocardial Infarction","status":"RECRUITING","sponsor":"Rikke Sorensen","startDate":"2022-06-17","conditions":"Myocardial Infarction","enrollment":2808},{"nctId":"NCT05223335","phase":"PHASE4","title":"Clopidogrel Monotherapy in Patients With High Bleeding Risk","status":"COMPLETED","sponsor":"Mayo Clinic","startDate":"2022-03-29","conditions":"Bleeding Complications","enrollment":98},{"nctId":"NCT05773989","phase":"PHASE4","title":"Pharmacodynamic Outcomes in CCS Patients Treated With an Individualized Treatment Strategy","status":"UNKNOWN","sponsor":"St. Antonius Hospital","startDate":"2024-01-23","conditions":"Coronary Artery Disease, Platelet Reactivity","enrollment":88}],"_emaApprovals":[],"_faersSignals":[],"_approvalHistory":[],"publicationCount":5,"rwe":[],"genericFilers":[],"relatedDrugs":[],"labelChanges":[],"biosimilarFilings":[],"pricing":[],"formularyStatus":[],"manufacturing":[],"companionDiagnostics":[],"competitors":[],"timeline":[],"patents":[],"ownershipHistory":[],"trials":[],"biosimilars":[],"latestUpdates":[],"references":[],"tags":[],"ecosystem":[],"genericManufacturerList":[],"offLabel":[],"developmentCodes":[],"aliases":["Guided DAPT"],"phase":"marketed","status":"active","brandName":"CYP2C19 Genotype Guided DAPT","genericName":"CYP2C19 Genotype Guided DAPT","companyName":"Zunyi Medical College","companyId":"zunyi-medical-college","modality":"Small molecule","firstApprovalDate":"","aiSummary":"This is a pharmacogenomic-guided dual antiplatelet therapy (DAPT) strategy that uses CYP2C19 genotyping to optimize antiplatelet drug selection and dosing for improved cardiovascular outcomes. Used for Acute coronary syndrome (ACS) with percutaneous coronary intervention (PCI) and stent placement, Secondary prevention of stent thrombosis and recurrent cardiovascular events in CYP2C19 genotype-guided patient populations.","enrichmentLevel":3,"visitCount":0,"trialStats":{"total":0,"withResults":0},"verificationStatus":"verified","dataCompleteness":{"mechanism":true,"indications":true,"safety":true,"trials":true,"score":4}}