Pharmacogenetics and pharmacogenomics in psoriasis treatment: current challenges and future prospects.
BACKGROUND
Topical, systemic, oral disease modifying, and biologic agents are part of the armamentarium to manage psoriatic disease. The choice of therapy depends upon disease severity, relevant co-morbidities and patient preference. There is great variability in patient response with these agents, and there is still no clear method of selecting the preferred therapeutic agent for efficacy or lack of adverse events.


METHODS
This article will review the pharmacogenetic and pharmacogenomic targets that are currently known with respect to psoriasis vulgaris, and the most frequent co-morbidity of psoriasis, psoriatic arthritis.


CONCLUSIONS
Presently, no clinically actionable biomarker exists for any therapeutic agent used to treat psoriasis or psoriatic arthritis. The lack of validated outcome measures and conflicting results of open-label studies conducted may be attributed to a multitude of issues that confound discovery. Consequently, studies have been underpowered to identify genes or genetic variants worth translating to clinical practice. In order to achieve a pharmacogenetic/pharmacogenomic signature, improvements in study design of future investigations are required, including carefully designed prospective studies. It is imperative to combine known clinical, serological, and molecular markers with consistent outcomes and an adequate health economic evaluation before they can be adopted widely in clinical practice.
a Faculty of Medicine , Memorial University of Newfoundland , St. John's , NL , Canada.
Alison
A
Sutherland
a Faculty of Medicine , Memorial University of Newfoundland , St. John's , NL , Canada.
Rebecca J
RJ
Power
a Faculty of Medicine , Memorial University of Newfoundland , St. John's , NL , Canada.
Proton
P
Rahman
a Faculty of Medicine , Memorial University of Newfoundland , St. John's , NL , Canada.
Darren D
DD
O'Rielly
D000279:Administration, Cutaneous; D000284:Administration, Oral; D015535:Arthritis, Psoriatic / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D001685:Biological Factors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D003879:Dermatologic Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D010597:Pharmacogenetics / Q000379:methods*; D011565:Psoriasis / Q000188:drug therapy* / Q000235:genetics / Q000473:pathology; D012720:Severity of Illness Index
D001685:Biological Factors; D003879:Dermatologic Agents
Psoriasis; genetics; pharmacogenetics; pharmacogenomics; psoriatic arthritis