Predictive Biomarkers and Personalized Therapy: Use of Pharmacogenetic Testing in a Scandinavian Perspective

Basic Clin Pharmacol Toxicol. 2025 Mar;136(3):e70009. doi: 10.1111/bcpt.70009.

Abstract

Precision medicine has significantly advanced through the development of predictive biomarkers based on pharmacogenetic (PGx) testing. These tests identify interactions between drugs and genetic variants that influence patient responses to treatments. Understanding genetic variations in drug-metabolizing enzymes, receptors and transporters and their impact on pharmacokinetics and pharmacodynamics allows for the prediction of drug effects and side effects, enabling tailored treatments for different patient groups. This review focuses on drugs metabolized by cytochrome P450 (CYP450) enzymes, for example, citalopram and clopidogrel or transported by the solute carrier organic anion transporter family member 1B1 (SLCO1B1), for example, atorvastatin and simvastatin, with PGx dosing guidelines, in the context of consumption in Scandinavian countries. A major barrier to the widespread adoption of PGx tests in clinical practice has been healthcare professionals' uncertainty about their efficacy, complexity in result interpretation and questions regarding the evidence base. However, recent studies have demonstrated PGx testing has the potential to improve treatment outcomes, reduce adverse drug reactions and achieve cost savings. These findings underscore the potential of PGx testing as a valuable tool in clinical decision making, promoting its use in a pre-emptive manner to enhance patient care.

Keywords: drug consumption; drug–gene interaction; pharmacogenetics testing; precision medicine; predictive biomarkers.

Publication types

  • Review

MeSH terms

  • Biomarkers / metabolism
  • Clinical Decision-Making
  • Cytochrome P-450 Enzyme System / genetics
  • Cytochrome P-450 Enzyme System / metabolism
  • Drug-Related Side Effects and Adverse Reactions / genetics
  • Drug-Related Side Effects and Adverse Reactions / prevention & control
  • Humans
  • Liver-Specific Organic Anion Transporter 1 / genetics
  • Liver-Specific Organic Anion Transporter 1 / metabolism
  • Pharmacogenetics / methods
  • Pharmacogenomic Testing* / methods
  • Precision Medicine* / methods
  • Scandinavian and Nordic Countries

Substances

  • Cytochrome P-450 Enzyme System
  • SLCO1B1 protein, human
  • Liver-Specific Organic Anion Transporter 1
  • Biomarkers