[Ethnicity in pharmacogenetics]

Abstract

Individuals originating from different ethnic groups can respond differently to certain medicines. In this article, we differentiated persons with a European, African and Asian origin into three main groups. The combination of a fixed dose of isosorbide dinitrate and hydralazine (known as BiDil) was marketed specifically in the US for Afro-Americans with heart failure, as patients from this group respond less well to ACE inhibitors. Ethnic differences in the effects of medications are partly linked to genetic variations. These ethnicity-related differences in the effects of medicines could be caused by variations in the enzymes that metabolise medications, e.g. cytochrome P450 (CYP) or, genetic variations in the receptors to which these substances bind. These differences could have consequences for dosing. Besides the pharmacokinetic and pharmacodynamic differences, there are also ethnic differences related to undesirable effects: HLA-mediated hypersensitivity reactions, for example. Ethnicity is not a suitable basis for adjusting the dosages of medicines. Genotyping can prove helpful at times.