Sequential genome-wide association studies for monitoring adverse events in the clinical evaluation of new drugs.
Pharmacovigilance, the monitoring of adverse events (AEs), is an integral part in the clinical evaluation of a new drug. Until recently, attempts to relate the incidence of AEs to putative causes have been restricted to the evaluation of simple demographic and environmental factors. The advent of large-scale genotyping, however, provides an opportunity to look for associations between AEs and genetic markers, such as single nucleotides polymorphisms (SNPs). It is envisaged that a very large number of SNPs, possibly over 500,000, will be used in pharmacovigilance in an attempt to identify any genetic difference between patients who have experienced an AE and those who have not. We propose a sequential genome-wide association test for analysing AEs as they arise, allowing evidence-based decision-making at the earliest opportunity. This gives us the capability of quickly establishing whether there is a group of patients at high-risk of an AE based upon their DNA. Our method provides a valid test which takes account of linkage disequilibrium and allows for the sequential nature of the procedure. The method is more powerful than using a correction, such as Sidák, that assumes that the tests are independent.
Kelly
Patrick
P
Medical and Pharmaceutical Statistics Research Unit, The University of Reading, U.K. patrick.kelly@reading.ac.uk
Stallard
Nigel
N
Zhou
Yinghui
Y
Whitehead
John
J
Bowman
Clive
C
D016907:Adverse Drug Reaction Reporting Systems; D002986:Clinical Trials as Topic; D003627:Data Interpretation, Statistical; D064420:Drug-Related Side Effects and Adverse Reactions; D020022:Genetic Predisposition to Disease; D015894:Genome, Human; D006801:Humans; D010597:Pharmacogenetics / Q000379:methods*; D020641:Polymorphism, Single Nucleotide