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LEXICOMP Pharmacogenomics Reference Lexicomp is a vendor that provides clinical content and drug information reference tools for the health care industry. It is one of several companies under the Clinical Solutions division of Wolters Kluwer Health that includes major brands such as Lippincott Williams & Wilkins, Ovid, MedKnow, UpToDate, Medi-Span, Facts & Comparisons, Pharmacy OneSource and ProVation Medical. The Lexicomp series of products include a number of Drug Reference publications as well as online and mobile solution drug reference databases. One recent offering in the Lexicomp series of references is a Pharmacogenomics database which is available as a module accessible from their standard drug information reference database. This Pharmacogenomic reference is a reference database of genomic information that potentially influences the pharmacokinetic and/or pharmacodynamic properties of a particular medication. The database is unique in that access is embedded within the standard drug monograph as a link called “Genes of interest”. Once invoked a list of genes for which a published study references the drug of interest. The list of genes can include allelic variations of the drug target (receptor, enzyme etc) or genes that may affect the metabolism of other pharmacokinetic properties of the drug. Included is a brief synopsis of the literature regarding the reported genetic association/influence and a brief assessment of the potential clinical utility of the genetic information.

Inclusion of Pharmacogenomic information as a link within the drug monograph makes this information readily available to users of Lexicomp’s standard drug reference software, which is widely used in hospitals, offices and on many personal devices. For each ‘Genes of Interest’ that is listed, when accessed, a monograph is launched that includes a listing of relevant terms used to reference the gene, the chromosome location, clinically relevant polymorphisms and a synopsis of the relevant information. A description of the genotype variations that might influence drug action is provided in the referenced studies of the polymorphism. Included are also descriptions of relevant gene-disease associations that may be associated with the medication. Specific mention is made of whether the gene variation is proposed to affect the pharmacokinetics, the pharmacodynamics of the drug or influence disease predisposition. This is an annotated section that includes references to the relevant primary literature. Information regarding whether clinical testing is available for the gene of interest is provided.

The number of reports relating variation in gene sequence/structure that potentially influence drug responses is growing rapidly. Having a resource to that literature that is specifically collated and presented with the context of a drug monograph is a useful way to approach to finding information on genetic influences on drug action. This is one example of a reference resource that connects published genetic information to a drug in an easily accessible format by using a link to collated and summarized information within a standard drug reference. There still remains the question of which allelic variant does the patient have and this needs to be answered before direct applicability in the clinic can be realized. As the cost of sequencing individual genomes becomes approachable for the health care system, knowing which variant a particular patient carries will make the information presented in the Lexicomp reference more actionable.


Submitted by (LeRoy Hanchett)