The British Pharmacological Society and the British Journal of Clinical Pharmacology are proud to announce the publication of the UK’s first clinical guideline in pharmacogenomics, developed by the UK Centre of Excellence in Regulatory Science and Innovation in Pharmacogenomics (UK CERSI-PGx). This milestone represents a significant step towards embedding personalised medicine into routine clinical practice across the NHS.
The guideline focuses on CYP2C19 genotyping for patients prescribed clopidogrel, a widely used antiplatelet therapy for conditions such as coronary artery disease and stroke prevention.
Evidence shows that clopidogrel’s effectiveness varies depending on genetic differences in CYP2C19, an enzyme critical for converting the drug into its active form. Up to 30% of white patients and as many as 60% of Asian patients carry variants that reduce enzyme activity, making clopidogrel less effective, a challenge that can be addressed through a simple genetic test.
Rather than replicating international guidance from CPIC and DPWG, this UK-specific guideline delivers practical, clinically focused recommendations, including:
- Eligibility for testing and integration into care pathways
- Variants to test and turnaround times
- Actions based on genotype
- Health economic considerations
- Evidence gaps and future research priorities
This work aligns with the NHS Long Term Plan, which commits to integrating pharmacogenomics into mainstream care. By supporting clinicians, regulators, and industry with clear, actionable guidance, these recommendations will help accelerate the adoption of precision prescribing, leading to improved patient outcomes, and a reduction in avoidable adverse drug reactions.
Professor Sir Munir Pirmohamed, Centre Lead at the University of Liverpool, emphasised:
With the new CERSI-PGx guideline for clopidogrel, we aim to ensure patients are prescribed the right treatment at the right dose, based on their genetics. By integrating CYP2C19 testing into routine pathways, we can improve efficacy, reduce adverse drug reactions, ease pressure on the NHS, and support cost-effective, precision prescribing.
The guideline and accompanying editorial are published in the British Journal of Clinical Pharmacology, reinforcing our commitment to advancing pharmacogenomics and supporting the UK’s leadership in regulatory science and innovation.
UK CERSI-PGx is led by the University of Liverpool, and funded by Innovate UK and the Medical Research Council, in conjunction with the MHRA, as part of the UK’s network of seven Centres of Excellence for Regulatory Science and Innovation. Collaborators in CERSI-PGx include The University of Manchester, Queen Mary University of London, Bangor University, The Office of Health Economics, The British Pharmacological Society, JS O’Brien Business Solutions, and Alderley Lighthouse Labs.
