Therapeutic regimens in interstitial lung disease guided by genetic screening: fact or fiction?

Drug-induced pulmonary toxicity is a serious and expanding problem 1, 2. Since the mid 1980s, the understanding of the metabolism of pharmaceuticals has increased substantially. Not least because of the introduction of molecular biological techniques, defects in drug-metabolising pathways have been elucidated. Nowadays, pharmacogenetics can guide the clinician in the choice of the best therapeutic regimen, resulting in “personalised medicine” 3. A decreased drug efficacy and unexpected and serious adverse drug reactions (ADR) are major threats to patients and occur more frequently than expected. Considerable efforts are needed to treat these ADR 4. Therefore, prevention of ADR is of utmost importance for the patient and the clinician. ADR can be due to inherited defects in drug activation, which mostly lead to decreased efficacy of the treatment, or to defects in drug-metabolising enzymes; the …

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