Systematic Review of Pharmacogenomics in Psoriasis

Despite considerable promise, translation of pharmacogenomic studies of drug efficacy and toxicity into clinical practice has been poor, with most advances occurring in the field of cancer. Arguably, with excellent access to diseased tissue and good measures of response, there should be less of a barrier to such translation in psoriasis. However, no studies to date have translated into clinical care. We performed a systematic review of publications assessing the influence of genomic variation on treatment response in psoriasis. Four electronic databases were searched from their inception dates to August 2012. A total of 46 studies, published between 1995 and 2012, met inclusion criteria. Common methodological flaws in studies included lack of calculating a priori power to detect association. Sources of clinical heterogeneity included: different strategies for phenotyping subjects and variability in the definition of treatment response. Whilst numerous examples of good practice were identified, overall the studies lacked detailed, reproducible methodology thereby obviating fair inter-study comparison of results. If pharmacogenomic studies in psoriasis are to translate into clinical care we propose employing standardised methodology and reporting criteria.