AUTHOR=Shubbar Qamar , Alchakee Aminah , Issa Khaled Walid , Adi Abdul Jabbar , Shorbagi Ali Ibrahim , Saber-Ayad Maha 

TITLE=From genes to drugs: CYP2C19 and pharmacogenetics in clinical practice

JOURNAL=Frontiers in Pharmacology

VOLUME=15

YEAR=2024

URL=https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2024.1326776

DOI=10.3389/fphar.2024.1326776

ISSN=1663-9812

ABSTRACT=<p>The <italic>CYP2C19</italic> gene is frequently included in different pharmacogenomic panels tested in clinical practice, due to its involvement in the metabolism of a myriad of frequently prescribed medications. Accordingly, <italic>CYP2C19</italic> genotyping can promote precise therapeutic decisions and avoid the occurrence of significant drug-drug-gene interactions in the clinical setting. A comprehensive examination of the role of the <italic>CYP2C19</italic> gene in real-world medical settings is presented in this review. This review summarizes the most recent information on how genetic variants in <italic>CYP2C19</italic> affect drug metabolism and therapeutic outcomes. It goes into the wide range of CYP2C19 phenotypes, with different degrees of metabolizing activity, and their implications for customized medication response through a review of the literature. The review also analyzes the clinical significance of <italic>CYP2C19</italic> in several medical specialties, including cardiology, psychiatry, and gastro-enterology clinics, and illuminates how it affects pharmacological efficacy, safety, and adverse effects. Finally, <italic>CYP2C19</italic>-supported clinical decision-making is outlined, highlighting the possibility of improving therapeutic outcomes and achieving more affordable treatment options, a step towards optimizing healthcare provision through precision medicine.</p>