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A systematic review of pharmacoeconomic assessments of the effectiveness for preliminary pharmacogenetic testing of the RAAS system genes in patients receiving ACE inhibitors

[Reviews]
Olga Vladimirovna Komarova; Bela Ismailovna Kantemirova; Alexandra Nikolaevna Romanova;

The systematic review was carried out subject to the PRISMA criteria and aimed to offer a pharmacoeconomic assessment regarding the implementation of pre-FGT RAAS genes in patients with CCH receiving APF inhibitors. The authors analyzed studies with full and partial economic estimates of the effectiveness of preliminary FGT in patients receiving APF inhibitors that were available in national and international databases. The final version of the review included 10 publications released between 2007 and 2024, with a total sample size of 10 907 patients. The collected data suggests that preliminary TGF in patients taking APF inhibitors was more often economically viable despite high variability of results.

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References:
1. Ignatieva V. I., Kontsevaya A.V., Lukyanov M. M., Klyashtorny V. G., Drapkina O. M. Clinical and economic analysis of increasing drug therapy coverage in patients with coronary artery disease in combination with atrial fibrillation and chronic heart failure. Kardiovaskulyarnaya terapiya i profilaktika. – Cardiovascular therapy and prevention. 2024;23(4):3950. (In Russ.). https://doi.org/10.15829/1728-8800-2024-3950
2. Berm E. J., Looff M. d., Wilffert B. Boersma C., Annemans L. [et al.]. Economic evaluations of pharmacogenetic and pharmacogenomic screening tests: A systematic review. Second update of the literature. PLoS One. 2016;11(1):e0146262. https://doi.org/10.1371/journal.pone.0146262
3. Hess G. P., Fonseca E., Scott R., Fagerness J. Pharmacogenomic and pharmacogenetic-guided therapy as a tool in precision medicine: current state and factors impacting acceptance by stakeholders. Genet. Res. (Camb). 2015;97:e13. https://doi.org/10.1017/S0016672315000099
4. Mosch R., van der Lee M., Guchelaar H. J., Swen J. J. Pharmacogenetic panel testing: a review of current practice and potential for clinical implementation. Ann. Rev. Pharmacol. Toxicol. 2025;65(1):91-109. https://doi.org/10.1146/annurev-pharmtox-061724-080935
5. Lteif C., Gawronski B. E., Cicali E. J., Martinez K. A., Newsom K. J. [et al.]. Development of an ancestrally inclusive preemptive pharmacogenetic testing panel. Clin. Transl. Sci. 2025;18(5):e70230. https://doi.org/10.1111/cts.70230
6. Bozina N., Vrkic Kirhmajer M., Simicevic L., Ganoci L., Mirosevic Skvrce N. [et al.]. Use of pharmacogenomics in elderly patients treated for cardiovascular diseases. Croat Med. J. 2020;61(2):147-158. https://doi.org/10.3325/cmj.2020.61.147
7. Timasheva Ya. R., Gerasimova K. A., Tuktarova I. A., Erdman V. V., Nasibullin T. R. Polygenic analysis of hereditary predisposition to essential hypertension. Arterial’naja gipertenzija. – Arterial hypertension. 2022;28(1):33-45. (In Russ.). https://doi.org/10.18705/1607-419X-2022-28-1-33-45
8. Rebrova E. V., Shikh E. V. Influence of genetic polymorphism of genes encoding the target of action on the effectiveness of antihypertensive therapy. Klinicheskaja farmakologija i terapija. – Clinical pharmacology and therapy. 2024;33(1):59-66. (In Russ.). https://doi.org/10.32756/0869-5490-2024-1-59-66
9. Siu W. S., Maruf A. A., Shaheen S. M., McCloud R., Heintz M. [et al.]. Estimating the frequency of falsenegative pharmacogenetic test results by self-reported ancestry. Clin. Pharmacol. Ther. 2025;118(2):331-336. https://doi.org/10.1002/cpt.3697
10. Trevisano R. G., Matias H., de Jesus Teani T., Silvino V. O., Ferreira C. P. [et al.]. The frequency of the ACE I/D polymorphism in South America: a systematic review and meta-analysis. Mol. Cell. Biochem. 2024;479(11):2955-2972. https://doi.org/10.1007/s11010-023-04923-9
11. Bartakova J., Deissova T., Slezakova S., Bartova J., Petanova J. [et al.]. Association of the angiotensin I conver ting enzyme (ACE) gene polymorphisms with recurrent aphthous stomatitis in the Czech population: case-control study. BMC Oral Health. 2022;22(1):80. https://doi.org/10.1186/s12903-022-02115-3
12. Atadzhanov M., Mwaba M. H., Mukomena P. N., Lakhi S., Mwaba P. [et al.]. Frequency of APOE, MTHFR and ACE polymorphisms in the Zambian population. BMC Res. Notes. 2014;7:194. https://doi.org/10.1186/1756-0500-7-194
13. Isordia-Salas I., Santiago-German D., Cerda-Mancillas M. C., Hernandez-Juarez J., Bernabe-Garcia M. [et al.]. Gene polymorphisms of angiotensin-converting enzyme and angiotensinogen and risk of idiopathic ischemic stroke. Gene. 2019;688:163-170. https://doi.org/10.1016/j.gene.2018.11.080
14. Birhan T. A., Molla M. D., Abdulkadir M., Tesfa K. H. Association of angiotensin-converting enzyme gene insertion/deletion polymorphisms with risk of hypertension among the Ethiopian population. PLoS One. 2022;17(11):e0276021. https://doi.org/10.1371/journal.pone.0276021
15. Wang L., Song T. T., Dong C. W. Association between interactions among ACE gene polymorphisms and essential hypertension in patients in the Hefei Region, Anhui, China. J. Renin Angiotensin Aldosterone Syst. 2023:1159973. https://doi.org/10.1155/2023/1159973
16. Gu Y., Shih S. T. F., Geevasinga N., Chan L., Frew J. W. [et al.]. Economic Evaluation of HLA-B*15:02 Genotyping for Asian Australian Patients with Epilepsy. JAMA Dermatol. 2024;160(6):631-640. https://doi.org/10.1001/jamadermatol.2024.1037
17. Brooks G. A., Tapp S., Daly A. T., Busam J. A., Tosteson A. N. A. Cost-effectiveness of DPYD genotyping prior to fluoropyrimidine-based adjuvant chemotherapy for colon cancer. Clin. Colorectal Cancer. 2022;21(3):e189-e195. https://doi.org/10.1016/j.clcc.2022.05.001
18. Carroll J., Lopez Manzano C., Tomlinson E., Sadek A., Cooper C. [et al.]. Clinical and cost-effectiveness of clopidogrel resistance genotype testing after ischaemic stroke or transient ischaemic attack: a systematic review and economic model. Health Technol. Assess. 2024;28(57):1-194. https://doi.org/10.3310/PWCB4016
19. Zhang Z., Bao Y., Gu Y., Zhang M., Li X. Cost-effectiveness analysis of CYP2C19 genotype-guided antiplatelet therapy for patients with acute minor ischemic stroke and high-risk transient ischemic attack in China. Br. J. Clin. Pharmacol. 2024;90(2):483-492. https://doi.org/10.1111/bcp.15921
20. Koufaki M. I., Fragoulakis V., Diaz-Villamarin X., Karamperis K., Vozikis A. [et al.]. Economic evaluation of pharmacogenomic-guided antiplatelet treatment in Spanish patients suffering from acute coronary syndrome participating in the U-PGx PREPARE study. Hum. Genomics. 2023;17(1):51. https://doi.org/10.1186/s40246-023-00495-3
21. Page M. J., McKenzie J. E., Bossuyt P. M., Boutron I., Hoffmann T. C. [et al.]. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71. https://doi.org/10.1136/bmj.n71
22. Mueller M., D’Addario M., Egger M., Cevallos M., Dekkers O. [et al.]. Methods to systematically review and meta-analyse observational studies: a systematic scoping review of recommendations. BMC Med. Res. Methodol. 2018;18(1):44. https://doi.org/10.1186/s12874-018-0495-9
23. Rethlefsen M. L., Kirtley S., Waffenschmidt S., Ayala A. P., Moher D. [et al.]. PRISMA-S: an extension to the PRISMA Statement for Reporting Literature Searches in Systematic Reviews. Syst. Rev. 2021;10(1):39. https://doi.org/10.1186/s13643-020-01542-z
24. Elsman E. B. M., Baba A., Offringa M. PRISMA-COSMIN steering committee. PRISMA-COSMIN 2024: New guidance aimed to enhance the reporting quality of systematic reviews of outcome measurement instruments. Int. J. Nurs. Stud. 2024;160:104880. https://doi.org/10.1016/j.ijnurstu.2024.104880
25. Nezameslami R., Nezameslami A., Mehdikhani B., Mosavi-Jarrahi A., Shahbazi A. [et al.]. Adapting PRISMA guidelines to enhance reporting quality in genetic association studies: a framework proposal. Asian Pac. J. Cancer Prev. 2025;26(5):1641-1651. https://doi.org/10.31557/APJCP.2025.26.5.1641
26. Rethlefsen M. L., Page M. J. PRISMA 2020 and PRISMA-S: common questions on tracking records and the flow diagram. J. Med. Libr. Assoc. 2022;110(2):253-257. https://doi.org/10.5195/jmla.2022.1449
27. Rebrova O. Yu., Fedyaeva V. K. Metaanalyses and assessment of their methodological quality. Russian version of the AMSTAR questionnaire. Medicinskie tehnologii. Ocenka i vybor. – Medical technologies. Evaluation and selection. 2016;1(23). Available at: www.cyberleninka.ru/article/n/meta-analizy-i-otsenkaih-metodologicheskogo-kachestva-russkoyazychnaya-versiya-voprosnika-amstar. Accessed September 23,2025. (In Russ.).
28. Shea B. J., Reeves B. C., Wells G., Thuku M., Hamel C. [et al.]. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both. BMJ. 2017;358:j4008. https://doi.org/10.1136/bmj.j4008
29. Sterne J. A. C., Savovic J., Page M. J., Elbers R. G., Blencowe N. S. [et al.]. RoB 2: a revised tool for assessing risk of bias in randomised trials. BMJ. 2019;366:l4898. https://doi.org/10.1136/bmj.l4898
30. Adarkwah C. C., van Gils P. F., Hiligsmann M., Evers S. M. A. A. Risk of bias in model-based economic evaluations: the ECOBIAS checklist. Expert Rev. Pharmacoecon. Outcomes Res. 2016;16(4):513-523. https://doi.org/10.1080/14737167.2016.1194759
31. Kelley E. F., Snyder E. M., Alkhatib N. S., Snyder S. C., Sprissler R. [et al.]. Economic evaluation of a pharmacogenomic multi-gene panel test to optimize anti-hypertension therapy: simulation study. J. Med. Econ. 2018;21(12):1246-1253. https://doi.org/10.1080/13696998.2018.1531011
32. Costa-Scharplatz M., van Asselt A. D., Bachmann L. M., Kessels A. G., Severens J. L. Cost-effectiveness of pharmacogenetic testing to predict treatment response to angiotensin-converting enzyme inhibitor. Pharmacogenet. Genomics. 2007;17(5):359-368. https://doi.org/10.1097/01.fpc.0000236336.34175.e8
33. Lim K. K., Koleva-Kolarova R., Kamaruzaman H. F., Kamil A. A., Chowienczyk P. [et al.]. Genetic-guided pharmacotherapy for coronary artery disease: a systematic and critical review of economic evaluations. J. Am. Heart Assoc. 2024;13(5):e030058. https://doi.org/10.1161/JAHA.123.030058
34. Oemrawsingh R. M., Akkerhuis K. M., Van Vark L. C., Redekop W. K., Rudez G. [et al.]. Individualized angiotensin-converting enzyme (ACE) inhibitor therapy in stable coronary artery disease based on clinical and pharmacogenetic determinants: the PERindopril GENEtic (PERGENE) risk model. J. Am. Heart Assoc. 2016;5(3):e002688. https://doi.org/10.1161/JAHA.115.002688
35. Luzum J. A., Lanfear D. E. Pharmacogenetic risk scores for perindopril clinical and cost effectiveness in stable coronary artery disease: when are we ready to implement? J. Am. Heart Assoc. 2016;5(3):e003809. https://doi.org/10.1161/JAHA.116.003440
36. Vegter S., Perna A., Hiddema W., Ruggenenti P., Remuzzi G. [et al.]. Cost-effectiveness of ACE inhibitor therapy to prevent dialysis in nondiabetic nephropathy: influence of the ACE insertion/deletion polymorphism. Pharmacogenet. Genomics. 2009;19(9):695-703. https://doi.org/10.1097/FPC.0b013e3283307ca0
37. Geenen J. W., Baranova E. V., Asselbergs F. W., de Boer A., Vreman R. A. [et al.]. Early health technology assessments in pharmacogenomics: a case example in cardiovascular drugs. Pharmacogenomics. 2017;18(12):1143-1153. https://doi.org/10.2217/pgs-2017-0063
38. Brugts J. J., de Maat M. P., Boersma E., Witteman J. C., van Duijn C. [et al.]. The rationale and design of the PERindopril GENEtic association study (PERGENE): a pharmacogenetic analysis of angiotensin-converting enzyme inhibitor therapy in patients with stable coronary artery disease. Cardiovasc. Drugs Ther. 2009;23(2):171-181. https://doi.org/10.1007/s10557-008-6156-1
39. Brugts J. J., de Maat M. P., Danser A. H., Boersma E., Simoons M. L. Individualised therapy of angiotensin converting enzyme (ACE) inhibitors in stable coronary artery disease: overview of the primary results of the PERindopril GENEtic association (PERGENE) study. Neth. Heart J. 2012;20(1):24-32. https://doi.org/10.1007/s12471-011-0173-6
40. Rysz J., Franczyk B., Rysz-Gorzynska M., Gluba-Brzozka A. Pharmacogenomics of hypertension treatment. Int. J. Mol. Sci. 2020;21(13):4709. https://doi.org/10.3390/ijms2113470

Keywords: systematic review, cardiovascular diseases, preliminary pharmacogenetic testing, gene polymorphism, renin-angiotensin-aldosterone system, APF inhibitors


Founders:
Stavropol State Medical Academy
Pyatigorsk State Research Institute of Balneotherapeutics
Pyatigorsk State Pharmaceutical Academy