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CVS Caremark Study Shows Genetic Marker For Improving Medication Safety Is Underutilized In Cardiovascular Treatment Prescribing

WOONSOCKET, R.I., Nov. 13, 2013 /PRNewswire/ -- A new study conducted by researchers at CVS Caremark (NYSE: CVS) and Brigham and Women's Hospital explores the impact of genetic testing on prescribing patterns for cardiovascular therapy.  The study, published in the November issue of the American Heart Association journal Circulation: Cardiovascular Quality and Outcomes,  found that only one in five patients who tested as poor metabolizers of the blood thinner clopidogrel had their antiplatelet therapy changed as recommended by the U. S. Food and Drug Administration (FDA).  In addition, the study found that prescribers declined genetic testing in 25 percent of cases evaluated, while less than 10 percent of patients who were directly offered the genetic evaluation declined testing. The researchers concluded that the prescribing patterns noted in the study likely reflect the unclear impact and physician uncertainty regarding the rapidly evolving body of evidence for pharmacogenomics.

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"We're entering an age when we can begin to create tailored treatment regimens for individual patients, but a genetic test is only valuable when providers and their patients can understand and act on the results," said Troyen A. Brennan, MD, MPH, executive vice president and chief medical officer of CVS Caremark and a study co-author.  "This research shows there is an opportunity to improve upon the information doctors and patients receive on this evolving topic so that they can make the best treatment decisions."

The study examined prescribing patterns for patients with recent acute coronary syndrome (ACS) or percutaneous coronary intervention (PCI) who were prescribed the antiplatelet medication clopidogrel.  While clopidogrel has been shown to reduce the risk of major adverse cardiovascular events for these patients, there is significant variability in how individual patients respond to the drug.  In fact, patients who are poor metabolizers of clopidogrel may have reduced therapeutic benefit and a higher risk of adverse cardiovascular events.  The FDA has advised avoiding the use of clopidogrel in patients who are poor metabolizers and recently modified the boxed warning to advise health care professionals to consider the use of other antiplatelet medications or alternative dosing strategies for poor metabolizers.

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