Apolipoprotein E genotyping for pharmacogenetic purposes in Alzheimer's disease: emerging ethical issues.
OBJECTIVE
To present some of the ethical concerns pertaining to the anticipated use of apolipoprotein E genotyping in selecting therapy in Alzheimer's disease.


METHODS
We review studies that support the utility of apolipoprotein E (APO E) genotyping for predicting drug responsiveness along with the published consensus statements and position papers related to APO E genotyping. Ethical issues pertaining to the use of APO E genotyping for pharmacogenetic purposes have not yet been fully explored, and these are discussed.


RESULTS
This paper explores the bioethics surrounding the use of APO E genotyping for pharmacogenetic purposes. The rapidly increasing pace of clinical trials in Alzheimer's disease necessitates a critical examination of the evolving ethical issues. A framework for establishing guidelines is suggested.


CONCLUSIONS
Clinical research trials for Alzheimer's disease with a genotyping component will increasingly be influenced by and benefit from a serious analysis of the ethics emerging alongside the scientific and clinical advances.
Issa
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Biomedical Ethics Unit, Faculty of Medicine, McGill University, Montreal, Quebec. amalia_issa@hms.harvard.edu
Keyserlingk
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D000544:Alzheimer Disease / Q000188:drug therapy / Q000235:genetics*; D001057:Apolipoproteins E / Q000235:genetics*; D004992:Ethics, Medical; D005838:Genotype; D006801:Humans; D018697:Nootropic Agents / Q000627:therapeutic use*; D018579:Patient Selection; D010597:Pharmacogenetics; D016896:Treatment Outcome
D001057:Apolipoproteins E; D018697:Nootropic Agents