Pharmacogenomic testing in paediatrics: Clinical implementation strategies
British Journal of Clinical Pharmacology, vol. 88, pp. 4297–4310
Abstract
Pharmacogenomics (PGx) relates to the study of genetic factors determining variability in drug response. Implementing PGx testing in paediatric patients can enhance drug safety, helping to improve drug efficacy or reduce the risk of toxicity. Despite its clinical relevance, the implementation of PGx testing in paediatric practice to date has been variable and limited. As with most paediatric pharmacological studies, there are well-recognised barriers to obtaining high-quality PGx evidence, particularly when patient numbers may be small, and off-label or unlicensed prescribing remains widespread. Furthermore, trials enrolling small numbers of children can rarely, in isolation, provide sufficient PGx evidence to change clinical practice, so extrapolation from larger PGx studies in adult patients, where scientifically sound, is essential. This review paper discusses the relevance of PGx to paediatrics and considers implementation strategies from a child health perspective. Examples are provided from Canada, the Netherlands and the UK, with consideration of the different healthcare systems and their distinct approaches to implementation, followed by future recommendations based on these cumulative experiences. Improving the evidence base demonstrating the clinical utility and cost-effectiveness of paediatric PGx testing will be critical to drive implementation forwards. International, interdisciplinary collaborations will enhance paediatric data collation, interpretation and evidence curation, while also supporting dedicated paediatric PGx educational initiatives. PGx consortia and paediatric clinical research networks will continue to play a central role in the streamlined development of effective PGx implementation strategies to help optimise paediatric pharmacotherapy.
Authors 8
-
Charlotte I. S. Barker corresponding
Guy's Hospital · St Thomas' Hospital · King's College London · Guy's and St Thomas' NHS Foundation Trust
Affiliation as printed
Department of Clinical Genetics Guy's and St Thomas' NHS Foundation Trust London UK
Department of Medical & Molecular Genetics King's College London London UK
Department of Clinical Genetics, Guy's and St Thomas' NHS Foundation Trust, London, UK
Department of Medical & Molecular Genetics King's College London London UK
-
University of British Columbia · BC Children's Hospital
Affiliation as printed
Division of Translational Therapeutics, Department of Pediatrics University of British Columbia Vancouver British Columbia Canada
Pharmaceutical Outcomes Programme BC Children's Hospital Vancouver British Columbia Canada
Division of Translational Therapeutics, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
Pharmaceutical Outcomes Programme, BC Children's Hospital, Vancouver, British Columbia, Canada
-
Amsterdam UMC Location University of Amsterdam · University of Amsterdam
Affiliation as printed
Respiratory Medicine/Pediatric Respiratory Medicine, Academic Medical Center University of Amsterdam Amsterdam The Netherlands
Respiratory Medicine/Pediatric Respiratory Medicine, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
-
Western University · Robarts Research Institute
Affiliation as printed
Departments of Paediatrics, Physiology and Pharmacology and Medicine Western University London Ontario Canada
Molecular Medicine Group Robarts Research Institute London Ontario Canada
Departments of Paediatrics, Physiology and Pharmacology and Medicine, Western University, London, Ontario, Canada
Molecular Medicine Group, Robarts Research Institute, London, Ontario, Canada
-
University of Liverpool · Alder Hey Children's Hospital
Affiliation as printed
Department of Women's and Children's Health University of Liverpool Liverpool UK
NIHR Clinical Research Facility Alder Hey Children's Hospital Liverpool UK
Department of Women's and Children's Health, University of Liverpool, Liverpool, UK
NIHR Clinical Research Facility, Alder Hey Children's Hospital, Liverpool, UK
-
King's College London · Genomics England
Affiliation as printed
Department of Medical & Molecular Genetics King's College London London UK
Genomics England London UK
Department of Medical & Molecular Genetics King's College London London UK
Genomics England, London, UK
-
Jesse Joachim Swen Aachen Department of Clinical Pharmacy and Toxicology Leiden University Medical Center Leiden The Netherlands Department of Clinical Pharmacy and Toxicology
Leiden University Medical Center
Affiliation as printed
Department of Clinical Pharmacy and Toxicology Leiden University Medical Center Leiden The Netherlands
Leiden Network for Personalized Therapeutics Leiden The Netherlands
Department of Clinical Pharmacy and Toxicology, Leiden University Medical Center, Leiden, The Netherlands
Leiden Network for Personalized Therapeutics, Leiden, The Netherlands
-
University of British Columbia · BC Children's Hospital · BC Children's Hospital Research Institute
Affiliation as printed
BC Children's Hospital Research Institute Vancouver British Columbia Canada
Division of Translational Therapeutics, Department of Pediatrics University of British Columbia Vancouver British Columbia Canada
Pharmaceutical Outcomes Programme BC Children's Hospital Vancouver British Columbia Canada
BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
Division of Translational Therapeutics, Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada
Pharmaceutical Outcomes Programme, BC Children's Hospital, Vancouver, British Columbia, Canada
Cited by 54 stored of 54
No patents citing this paper on Lens.org (checked 2026-10-11).