Pharmacogenetic Testing for Methotrexate Treatment in Leukemia PatientsMuhammad Tahir M Bhinder, Amin Saleh Halum, Suhaib M Muflih and Mohammad Shawaqfeh1*
College of Pharmacy, Nova Southeastern University, FL, USA
- *Corresponding Author:
- Mohammad S Shawaqfeh
Pharm D, Ph.D, Nova Southeastern University
Palm Beach Gardens, FL, United States
E-mail: [email protected]
Received date: February 28, 2015 Accepted date: December 15, 2015 Published date: December 26, 2015
Citation: Bhinder MTM, Halum AS, Muflih SM, Shawaqfeh M (2015) Pharmacogenetic Testing for Methotrexate Treatment in Leukemia Patients. J Biomol Res Ther 4:134. doi:10.4172/2167-7956.1000134
Copyright: © 2015 Bhinder MTM, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: Pharmacogenetic testing can be used as a means to individualize a patient’s medical regimen in order to prevent future adverse drug events. Pharmacogenomics looks at individual genes and can predetermine a patient’s susceptibility to certain side effects of medications, as well as how efficacious a medication will be for that patient. Methotrexate has been shown to exhibit different responses based on the genetic expressions and variations of the genes SLC19A, SHMT, ABCB1, ATIC and MTHFR.
Objective: To determine the clinical relevance of pharamcogenetic testing for leukaemia patients treated with Methotrexate.
Method: A systematic review was conducted from September 2013-August 2015, primarily using the EMBASE and PubMed databases, identifying Cochrane reviews, controlled clinical trials, randomized control trials, meta-analyses and systematic reviews. Search terms that were initially included were the name of the genes individually (SLC19A, SHMT, ABCB1, ATIC and MTHFR), methotrexate, and leukemia. The results were further limited to English and those conducted on humans. Two reviewers extracted data and evaluated pertinent studies. A total of 82 articles were found, but were then narrowed down to 34 articles. The 34 articles were graded with the JADAD scale, with scores ranging from of 0-5 points. They were then evaluated for clinical relevance, and were reduced to 10 articles to be analysed for the purpose of the study.
Results: Of the 34 article graded, 26 articles had a score of 0 points.
Conclusion: Although there is significant evidence of an association between the clinical effects of methotrexate in leukemia patients and these genes, based on their JADAD scores, there appears to be a lack of high evidence clinical studies. None of the article found included randomized controlled trials, despite compelling evidence indicating a need for these high quality studies in order to administer methotrexate to patients in a safer manner.