Sara Osama, one of the candidates who this year successfully completed the postgraduate Doctorate in Pharmacy degree at the Department of Pharmacy of the University of Malta in collaboration with the University of Illinois at Chicago, presented key findings of her dissertation as an oral communication during the annual Maltese Cardiac Society Conference, held from 15 to 17 October 2020.
The research, which looked at the value of including pharmacogenetic testing as one of the considerations in optimising antiplatelet therapy, was awarded the prize for best research abstract during the conference. The research was supervised by Dr Francesca Wirth from the Department of Pharmacy and was carried out in collaboration with the Departments of Cardiology and Pathology at Mater Dei Hospital.
The research was supported by a University of Malta Research Grant (PHRRP12-19).
Clopidogrel is an antiplatelet drug prescribed after percutaneous coronary intervention (PCI) to decrease the risk of thrombotic complications. Conversion of clopidogrel to its active metabolite is required for efficacy of the drug. Pharmacogenetic testing helps to identify patients who are carriers of the loss-of-function CYP2C19 *2 allele, which indicates that they are unable to metabolise the drug efficiently.
The matched case-control study undertaken by Dr Osama showed a statistically significant association (p<0.001) between the CYP2C19*2 genetic polymorphism and coronary in-stent restenosis complication within one year after PCI in patients prescribed clopidogrel.
The research findings indicate that CYP2C19*2 genotyping may be used as a tool, together with consideration of non-genetic risk factors, to select the most appropriate antiplatelet drug for the individual patient candidates to improve patient prognosis. Pharmacogenetic testing may be undertaken using rapid, point-of-care genotyping assays that have been tested in previous PhD research carried out at the Department of Pharmacy of the University of Malta.