Original Article

The Pharmacogenomics Journal advance online publication 26 February 2008; doi: 10.1038/tpj.2008.4

Genome-wide approaches to identify pharmacogenetic contributions to adverse drug reactions

M R Nelson1, S-A Bacanu1, M Mosteller1, L Li1, C E Bowman1, A D Roses1, E H Lai1 and M G Ehm1

1Pharmacogenetics, GlaxoSmithKline, Research Triangle Park, NC, USA

Correspondence: Dr MR Nelson, Pharmacogenetics, GlaxoSmithKline, 5 Moore Drive, MAI.A1227, Research Triangle Park, NC 27709-3398, USA. E-mail: matthew.r.nelson@gsk.com

Received 18 July 2007; Revised 27 November 2007; Accepted 4 January 2008; Published online 26 February 2008.

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Abstract

Adverse drug reactions (ADRs) have a major impact on patients, physicians, health care providers, regulatory agencies and pharmaceutical companies. Identifying the genetic contributions to ADR risk may lead to a better understanding of the underlying mechanisms, identification of patients at risk and a decrease in the number of events. Technological advances have made the routine monitoring and investigation of the genetic basis of ADRs during clinical trials possible. We demonstrate through simulation that genome-wide genotyping, coupled with the use of clinically matched or population controls, can yield sufficient statistical power to permit the identification of strong genetic predictors of ADR risk in a prospective manner with modest numbers of ADR cases. The results of a 500 000 single nucleotide polymorphism analysis of abacavir-associated hypersensitivity reaction suggest that the known HLA-B gene region could be identified with as few as 15 cases and 200 population controls in a sequential analysis.

Keywords:

adverse drug reaction, genome-wide association, pharmacogenetics, power analysis, abacavir-associated hypersensitivity

Abbreviations:

ABC, abacavir; ADR, adverse drug reaction; GRR, genotype relative risk; HSR, hypersensitivity reaction; LD, linkage disequilibrium; MHC, major histocompatibility complex; SNP, single nucleotide polymorphism

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