Genetic Variability in Clopidogrel Metabolism Exposes Inequities in Coronary Artery Disease Treatment
Original framing: “[Correspondence] Clopidogrel versus aspirin for coronary artery disease” — The Lancet
The development of pharmacogenomics has a complex history, with early pioneers like Garrod and Garrod's work on alkaptonuria highlighting the importance of genetic variation in disease susceptibility. However, the field has also been shaped by colonialism and the exploitation of Indigenous knowledge, leading to ongoing inequities in healthcare access and outcomes.
The efficacy of clopidogrel in preventing coronary artery disease is compromised by genetic variability in CYP2C19 metabolism, disproportionately affecting patients of certain ethnicities.
The UK National Institute for Health and Care Excellence's recommendation for CYP2C19 genotyping underscores the importance of addressing these inequities. By implementing universal genetic testing, conducting more diverse and inclusive clinical trials, developing community-based healthcare initiatives, and providing education and training for healthcare providers, we can develop more equitable and inclusive approaches to healthcare that address the unique needs and concerns of diverse populations.