TY - JOUR
T1 - Pharmacogenomic landscape in Thailand
T2 - Array-based profiling and EMR-linked medication exposure
AU - Pasookhush, Phongthana
AU - Suta, Sophida
AU - Pumeiam, Sureeporn
AU - Mongkolsucharitkul, Pichanun
AU - Pinsawas, Bonggochpass
AU - Ophakas, Suphawan
AU - Mayurasakorn, Korapat
N1 - Publisher Copyright:
Copyright: © 2026 Pasookhush et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2026
Y1 - 2026
N2 - Pharmacogenomic (PGx) data in Thailand remain limited, and genetics-only surveys rarely quantify "realized actionability"-the overlap between actionable PGx phenotypes and real-world medication exposure. We profiled 4,662 Thai adults using SNP-array data and a pre-specified PGx panel (11 genes; 26 markers) with a hybrid required/optional calling policy for diplotype/phenotype assignment. CPIC level A/B gene-drug relationships were linked to hospital electronic medical record (EMR) prescription/dispensation data to quantify drug-specific realized actionability. Overall callability across gene-results was 98.62%, exceeding 99% for most genes and lower for CYP2C19 (95.99%) and NUDT15 (90.28%). Across nine phenotype-coded genes, 95.99% carried ≥1 CPIC-actionable result (median 2; IQR 2-3). Actionable prevalence among callable individuals was highest for CYP3A5 (58.54%) and CYP2C19 (56.67%), followed by ABCG2 (45.10%) and UGT1A1 (27.37%). EMR linkage identified 1,529 (32.58%) participants exposed to ≥1 study medication; omeprazole (n = 658) and statins were most common (atorvastatin n = 606; simvastatin n = 603). Among users, actionable phenotypes were frequent for CYP2C19-omeprazole (55.02%) and SLCO1B1-statins (21.95-23.05%). In conclusion, an Asian-optimized SNP array supports scalable PGx phenotyping in Thai adults. EMR linkage quantifies realized actionability and highlights high-yield targets (CYP2C19-proton pump inhibitors; SLCO1B1-statins) for pre-emptive implementation.
AB - Pharmacogenomic (PGx) data in Thailand remain limited, and genetics-only surveys rarely quantify "realized actionability"-the overlap between actionable PGx phenotypes and real-world medication exposure. We profiled 4,662 Thai adults using SNP-array data and a pre-specified PGx panel (11 genes; 26 markers) with a hybrid required/optional calling policy for diplotype/phenotype assignment. CPIC level A/B gene-drug relationships were linked to hospital electronic medical record (EMR) prescription/dispensation data to quantify drug-specific realized actionability. Overall callability across gene-results was 98.62%, exceeding 99% for most genes and lower for CYP2C19 (95.99%) and NUDT15 (90.28%). Across nine phenotype-coded genes, 95.99% carried ≥1 CPIC-actionable result (median 2; IQR 2-3). Actionable prevalence among callable individuals was highest for CYP3A5 (58.54%) and CYP2C19 (56.67%), followed by ABCG2 (45.10%) and UGT1A1 (27.37%). EMR linkage identified 1,529 (32.58%) participants exposed to ≥1 study medication; omeprazole (n = 658) and statins were most common (atorvastatin n = 606; simvastatin n = 603). Among users, actionable phenotypes were frequent for CYP2C19-omeprazole (55.02%) and SLCO1B1-statins (21.95-23.05%). In conclusion, an Asian-optimized SNP array supports scalable PGx phenotyping in Thai adults. EMR linkage quantifies realized actionability and highlights high-yield targets (CYP2C19-proton pump inhibitors; SLCO1B1-statins) for pre-emptive implementation.
UR - https://www.scopus.com/pages/publications/105046484034
U2 - 10.1371/journal.pone.0355201
DO - 10.1371/journal.pone.0355201
M3 - Article
C2 - 42545959
AN - SCOPUS:105046484034
SN - 1932-6203
VL - 21
SP - e0355201
JO - PLoS ONE
JF - PLoS ONE
IS - 8
ER -