#324 Genetic Contraindications for Ozempic and Wegovy (GLP-1 Agonists)

With millions of people now taking GLP-1 agonists like Ozempic and Wegovy, I was curious to learn if there are known genetic mutations that predispose people to have serious side effects from these medications. So exploring the pharmacogenomic aspects of Ozempic and Wegovy.

To answer these questions Dr. Josiah Allen is joining the show. Josiah Allen, PharmD, has spent over 15 years in the field of pharmacogenomics, beginning at the Mayo Clinic where he helped develop the GeneSight test. As a founding employee and the first medical science liaison at Assurex Health, he helped GeneSight become one of the fastest growing molecular diagnostic tests in history.

He later served as director of medical affairs at OneOme and now works at St. Elizabeth Healthcare in Edgewood, KY, as a precision medicine pharmacist and PGY2 Clinical Pharmacogenomics pharmacy residency program director. He earned his bachelor's degree in psychology from Wheaton College and his Doctor of Pharmacy degree from the University of Minnesota.

In the recording, Dr. Allen teases that the Board of Pharmacy Specialties (BPS), the post-licensure certification organization serving the pharmacy profession, will issue a call for petition in pharmacogenomics. The board will be reviewing the petition and evaluating pharmacogenomics as a pharmacy specialty. In the days after we recorded this was released and you can find the full press release here.

Topics Covered:

• The basics of pharmacogenomics and its role in personalized medicine.
• How genetic mutations, like those in the RET gene, influence medication risks.
• The pharmacogenomics of GLP-1 agonists (like Ozempic and Wegovy), including their contraindications for patients with RET mutations.
• Insights into the overlap between ACMG secondary findings and pharmacogenomic implications.
• Case studies illustrating the real-world impact of pharmacogenomics.

Key Takeaways:

• GLP-1 agonists, such as Ozempic and Wegovy, carry a black box warning due to an association with thyroid cancer, particularly in individuals with RET gene mutations.
• Over one-third of the ACMG secondary findings genes have pharmacogenomic implications, emphasizing the need for clinicians to integrate genetic insights into prescribing practices.
• Pharmacists and geneticists need closer collaboration to bridge the gap between clinical genomics and pharmacogenomics for safer medication use.

Resources:

• GeneReviews
• PharmGKB
• Table of Pharmacogenomic Biomarkers in Drug Labeling
• FDA Black Box Warning on GLP-1 Agonists

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