The UK’s National Institute for Health and Care Excellence (Nice) has suggested that clinicians should provide laboratory-based genotype testing to stroke patients who have been recommended to receive the standard anti-clot drug clopidogrel.
The drug is currently recommended as a treatment option for those at risk of having another stroke after suffering an ischaemic stroke or transient ischaemic attack (TIA).
However, individuals with specific variations on the CYP2C19 gene cannot convert the drug for its use in the body, rendering the drug ineffective in such cases.
The genotype test will help determine individuals who carry these variants, allowing them to receive suitable and more effective treatment with an alternative drug that will prevent future blood clots.
NICE has suggested using the Genomadix Cube point-of-care test, in the event that laboratory testing is not feasible.
Based on the evidence, people carrying the CYP2C19 gene variants are expected to have a 46% higher risk of another stroke when taking clopidogrel than those without them.
NICE medical technology and digital evaluation interim director Mark Chapman said: “The recommendation is a step forward in ensuring people who have had a stroke receive personalised care thanks to a genetic test run after their DNA is sequenced using their blood or saliva.
“Treatment with clopidogrel is effective in preventing further strokes for the majority of people who don’t have the gene variant.
“If the CYP2C19 variants are found, other treatment options can be used. This test ensures we’re getting the best care to people quickly, while at the same time ensuring value for money for the taxpayer.”