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CYP2C19 genotype guided P2Y12 monotherapy
CYP2C19 genotype-guided P2Y12 monotherapy uses genetic testing to select appropriate P2Y12 inhibitor dosing or choice based on individual cytochrome P450 2C19 metabolizer status, optimizing antiplatelet efficacy while reducing bleeding risk.
CYP2C19 genotype-guided P2Y12 monotherapy uses genetic testing to select appropriate P2Y12 inhibitor dosing or choice based on individual cytochrome P450 2C19 metabolizer status, optimizing antiplatelet efficacy while reducing bleeding risk. Used for Acute coronary syndrome (ACS) and post-percutaneous coronary intervention (PCI) management in patients with known CYP2C19 genotype, Secondary prevention of thrombotic events in coronary artery disease.
At a glance
| Generic name | CYP2C19 genotype guided P2Y12 monotherapy |
|---|---|
| Also known as | Ticagrelor, Prasugrel, Clopidogrel |
| Sponsor | St. Antonius Hospital |
| Drug class | P2Y12 inhibitor (antiplatelet agent) |
| Target | P2Y12 receptor |
| Modality | Small molecule |
| Therapeutic area | Cardiovascular |
| Phase | FDA-approved |
Mechanism of action
P2Y12 inhibitors (such as clopidogrel, prasugrel, or ticagrelor) are antiplatelet agents that block the P2Y12 adenosine diphosphate receptor on platelets. CYP2C19 is a key enzyme in the metabolism of some P2Y12 inhibitors, particularly clopidogrel. Genetic variants in CYP2C19 affect drug metabolism rates; poor metabolizers may have reduced drug efficacy, while ultra-rapid metabolizers may have increased bleeding risk. Genotype-guided therapy tailors P2Y12 monotherapy selection or dosing to individual metabolizer phenotype, improving clinical outcomes in cardiovascular disease management.
Approved indications
- Acute coronary syndrome (ACS) and post-percutaneous coronary intervention (PCI) management in patients with known CYP2C19 genotype
- Secondary prevention of thrombotic events in coronary artery disease
Common side effects
- Bleeding (major and minor)
- Dyspnea
- Bradycardia
- Gastrointestinal bleeding
Key clinical trials
- Genotype-Guided Abbreviated DAPT Versus Un-Guided De-escalation Therapy in Patients With ACS and HBR (PHASE4)
- POPular GUILTY PILOT: Genotype-guided Clopidogrel Monotherapy (PHASE2)
- CYP2C19 Genotype-Guided P2Y12 Receptor Inhibitor Selection After Complex Percutaneous Coronary Intervention (PHASE4)
- Pharmacodynamic Outcomes in CCS Patients Treated With an Individualized Treatment Strategy (PHASE4)
Primary sources
Every claim on this page is sourced from regulatory or scientific primary sources. See our editorial policy for full methodology.
| Source | Used for |
|---|---|
| ClinicalTrials.gov | Trial enrolment, design, endpoints, results |
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