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Name:
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NATALIE DEMO
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Date of Birth:
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Coriell ID:
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DEMONAT
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Lab Accessioning Number:
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DEMONAT
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Ordering Physician:
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Gender:
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Female
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Date Collected:
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Date Received:
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Date of Report:
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01/11/2017
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CYP2C19 and Voriconazole Response
These results were generated in a CLIA-approved laboratory as part of the Coriell Personalized Medicine Collaborative research study.
Results take into account 10 genetic variants in the CYP2C19 gene, known to contribute to the metabolism of voriconazole.
This report reflects this participant’s metabolism status predicted based on genetic testing but does not reflect whether they are currently taking voriconazole.
The CPMC has genetic counselors available to assist with report interpretation
at no charge. For questions please contact us at cpmcgc@coriell.org
or by phone at 888-580-8028. Participants may schedule an appointment with one of our board certified
genetic counselors by logging into their web portal account and clicking on “request an appointment”.
For general information about the CPMC please visit our website
cpmc.coriell.org.
This research report includes all data included in the clinical report as well as supplemental
drug specific interpretations and educational material. Please see the report that follows for the official clinical report.
Your combination of genetic variant results is listed below in yellow.
Your CYP2C19* result is:
CYP2C19*4/*4
(Voriconazole Poor Metabolizer)
| VARIANTS TESTED | YOUR RESULT | REFERENCE VALUE |
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rs4244285 (CYP2C19*2)
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GG
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G G
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rs4986893 (CYP2C19*3)
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GG
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G G
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rs28399504 (CYP2C19*4)
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GG
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A A
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rs56337013 (CYP2C19*5)
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CC
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C C
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rs72558184 (CYP2C19*6)
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GG
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G G
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rs72558186 (CYP2C19*7)
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TT
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T T
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rs41291556 (CYP2C19*8)
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TT
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T T
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rs17884712 (CYP2C19*9)
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GG
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G G
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rs6413438 (CYP2C19*10)
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CC
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C C
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rs12248560 (CYP2C19*17)
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CC
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C C
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1When your variant result for all CYP2C19 variants tested are the same as the reference,
the combined genetic result is called CYP2C19*1/*1. In some cases your combined genetic result may be uncertain.
Other variants, not currently included in this CPMC test may influence this result and interpretation.
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Your combination of genetic variants indicates you are a voriconazole poor metabolizer with significantly decreased CYP2C19 activity.
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Poor metabolizers process voriconazole at a very slow rate and may be at increased risk for adverse reactions (vision problems, rash, elevated liver enzymes) when taking a standard dose of voriconazole.
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If prescribed voriconazole, talk to your doctor about appropriate monitoring or consider alternative treatment options.
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This result may also affect your response to other medications. For more information on other medications that are affected by the CYP2C19 gene, click here.
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Reduced CYP2C19 activity
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Poor Metabolizer
3
out of 100 people
May be at increased risk for adverse reaction.
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Intermediate Metabolizer
30
out of 100 people
May be at increased risk for adverse reaction.
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Typical CYP2C19 activity
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Extensive Metabolizer
36
out of 100 people
Expected to have a typical risk for adverse reaction.
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Increased CYP2C19 activity
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Ultra-Rapid Metabolizer
5
out of 100 people
Expected to have a typical risk for adverse reaction.
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Uncertain CYP2C19 activity
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Metabolizer Status Unknown
26
out of 100 people
Not enough data to determine risk for adverse reaction.
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Genetic Risk Factors
Genetic variants, or changes, in a gene called CYP2C19 can affect the way your body metabolizes voriconazole. Some people with certain genetic variants may be at increased risk for side effects from taking a standard dose of voriconazole compared to people without these variants.
Non-Genetic Risk Factors
Many factors affect how your body responds to medications.
Non-genetic factors include: diet, lifestyle, medical history and interactions between medications.
Genes Affecting Voriconazole Metabolism:
CYP2C19
Types of Variants in CYP2C19
There are many variants in the CYP2C19 gene. A number system has been created to
name common combinations of variants. Some variant combinations have not been assigned a number yet.
Other combinations of variants cannot be assigned a number with certainty.
We all have 2 copies of every gene; when possible, you will have a CYP2C19 result with two numbers.
Example: CYP2C19 *1/*2
Your personal result can be found
by clicking on the RESULTS tab
above.
The following medications, when taken with voriconazole,
may reduce the benefit of taking the other medication or
may increase the risk for side effects from the other medication:
| Medication | Also Known As | Type |
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Carbamazepine
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Tegretol®, Carbatrol®, Equetro®, and Epitol®
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Anticonvulsant
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Efavirenz, Ritonavir
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Sustiva® and Atripla®, Norvir®
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HIV Antiviral
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Ergotamine/Dihydroergotamine
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Cafergot®, Ergomar®
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Migraine Pain
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Phenobarbital
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Luminal®
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Long-acting barbituate
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Pimozide
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Orap®
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Antipsychotic
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Quinidine
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Quinaglute®, Quinidex®
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Antiarrhythmic
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Rifabutin, Rifampin
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Mycobutin®, Rifadin®
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Antibiotic
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Sirolimus
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Rapamune®
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Immunosuppressant
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For a selected list of other medications that can also affect your response to voriconazole, click here.
The following foods, vitamins, and supplements are known to interact with voriconazole (Vfend®):
St. John’s Wort
- St. John’s Wort is a medicinal herb that has antidepressant and anti-inflammatory properties.
- Avoid taking St. John’s Wort while taking voriconazole (Vfend®).
- Taking St. John’s Wort while taking voriconazole (Vfend®) reduces the amount of voriconazole available in the blood stream and may prevent voriconazole from working properly.
For a list of foods, vitamins, and supplements that may interact with voriconazole (Vfend®),
click here.
Share these results with your healthcare providers.
Print Report
DO NOT MAKE CHANGES TO ANY MEDICATION WITHOUT TALKING TO YOUR HEALTHCARE PROVIDERS.
Result Limitations
- This result alone does NOT predict your total response to voriconazole.
- Other factors such as body weight, various health conditions, and other medications may impact an individual’s response to voriconazole.
- There may be other genetic variants within the CYP2C19 gene which influence response to voriconazole but are not included in this test.
- There may be other genetic variants in the CYP2C19 gene for which response to voriconazole has not been documented and/or validated in multiple studies.
- There may be genetic variants in other genes that influence response to voriconazole.
- This result reflects published data available at the time this gene-drug pair was approved by the CPMC Informed Cohort Oversight Board (November 2016).
The information provided may change as new scientific information becomes available.
- Although rare, it is possible that you may receive an incorrect result; 100% accuracy of reported results cannot be guaranteed.
- Occasionally, we will be unable to interpret one or more gene variants.
In this case you will not receive a result for those variants and in some cases your
drug response cannot be interpreted. It is expected that you will receive results for about 95% of variants approved by the
Pharmacogenetics Advisory Group (PAG) and Informed Cohort Oversight Board (ICOB).
- Every effort will be made to provide you with risk information based on your reported race/ethnicity.
However, data may not be available for all races/ethnicities. Please see your individual results to determine which race/ethnicity the data is based on.
- In some cases, the CYP2C19 metabolizer status on your voriconazole report will be different than the CYP2C19 metabolizer
status on your Clopidogrel (Plavix®) report. For an explanation of why your CYP2C19 metabolizer status may be different for different drugs,
click here.
Test Limitations
DNA-based testing is highly accurate, however there are many sources of potential error including: mis-identification of samples, rare technical errors, trace contamination of PCR reactions, and rare genetic variants that interfere with analysis. This test or one or more of its components was developed and its performance characteristics determined by the Coriell Institute for Medical Research. It has not been approved by the Food and Drug Administration (FDA). The FDA has determined that such approval is not necessary. The Coriell Institute is regulated under the Clinical Laboratory Improvement Amendments (CLIA) of 1988 as qualified to perform high-complexity testing.
Test Methodology
Saliva samples were collected using Oragene DNA Collection Kits (DNA Genotek) and DNA was extracted manually according to the manufacturer’s instructions or automatically using a DNAdvance Kit (Agencourt). Purified DNA was quantified using UV absorbance at 260 nm. One microgram of the resulting DNA from each sample was used as template in the Affymetrix DMET Plus GeneChip assay. Data analysis was performed using Affymetrix DMET Console software.
To view your clinical report,
click here.
The clinical report contains the lab generated testing information and does not include all the content in the research study report.
[Risk interpretation based on Coriell’s CYP2C19/Voriconazole Response Genotype Translation Version 1 (January 2017)]
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