Heghine Khachatryan on a UK Milestone: National CYP2C19 Testing Before Clopidogrel Therapy
Heghine Khachatryan, Editor-in-Chief of Hemostasis Today, Head of Hemophilia and Thrombosis Center at Yeolyan Hematology and Oncology Center, shared a post by Lydia Kariuki on LinkedIn:
“Precision medicine in action: a milestone for antiplatelet therapy
The UK has taken a significant step toward truly personalized cardiovascular care by recommending routine CYP2C19 pharmacogenetic testing before initiating clopidogrel therapy within the NHS.
Clopidogrel remains a cornerstone antiplatelet agent for patients with coronary, cerebrovascular, and peripheral arterial disease. However, its clinical efficacy is highly dependent on CYP2C19-mediated bioactivation, leading to substantial inter-individual variability in response.
This national pharmacogenomic recommendation directly addresses a long-standing clinical challenge:
- reduced efficacy in CYP2C19 loss-of-function carriers
- preventable thrombotic events
- avoidable trial-and-error prescribing
Implementing PGx testing before treatment initiation allows clinicians to:
- identify non-responders early
- select alternative antiplatelet agents when appropriate
- improve outcomes while reducing complications
This is a powerful example of how pharmacogenomics can be translated into real-world clinical practice at a national level.
For countries and health systems striving to modernize cardiovascular care, this sets an important benchmark.
Precision medicine is no longer the future — it is becoming standard of care.”
Quoting Lydia Kariuki’s post:
“CYP2C19 pharmacogenetic (PGx) testing for all patients in the UK before prescribing clopidogrel
The UK has taken a major step forward in precision prescribing with the publication of its first national pharmacogenomic guideline, focused on the antiplatelet drug clopidogrel.
Clopidogrel is widely prescribed across the NHS to prevent blood clots in patients with coronary artery disease, cerebrovascular disease, and peripheral arterial disease. But while the medication is standard therapy, its effectiveness varies substantially between individuals. The new guideline directly addresses this variability by recommending CYP2C19 genotyping for patients before clopidogrel therapy is initiated.”
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