title: Pharmacogenetics in clinical pediatrics: challenges and strategies.
abstract: The use of genetic information to guide medication decisions holds great promise to improve therapeutic outcomes through increased efficacy and reduced adverse events. As in many areas of medicine, pediatric research and clinical implementation in pharmacogenetics lag behind corresponding adult discovery and clinical applications. In adults, genotype-guided clinical decision support for medications such as clopidogrel, warfarin and simvastatin are in use in some medical centers. However, research conducted in pediatric populations demonstrates that the models and practices developed in adults may be inaccurate in children, and some applications lack any pediatric research to guide clinical decisions. To account for additional factors introduced by developmental considerations in pediatric populations and provide pediatric patients with maximal benefit from genotype-guided therapy, the field will need to develop and employ creative solutions. In this article, we detail some concerns about research and clinical implementation of pharmacogenetics in pediatrics, and present potential mechanisms for addressing them.
authors.affiliation: Department of Pediatrics, Vanderbilt University, 2200 Children's Way, Nashville, TN 37232, USA ; The Monroe Carell Jr Children's Hospital at Vanderbilt, 8232 DOT, 2200 Children's Way, Nashville, TN 37232, USA.
authors.forename: Sara L
authors.initials: SL
authors.lastname: Van Driest
authors.affiliation: Department of Pediatrics, Vanderbilt University, 2200 Children's Way, Nashville, TN 37232, USA ; The Monroe Carell Jr Children's Hospital at Vanderbilt, 8232 DOT, 2200 Children's Way, Nashville, TN 37232, USA ; The Center for Human Genetics Research, 519 Light Hall, 2215 Garland Avenue, Nashville, TN 37232-0700, USA.
authors.forename: Tracy L
authors.initials: TL
authors.lastname: McGregor
keywords: clinical pharmacology; genomics; pediatrics; pharmacogenetics; pharmacogenomics