Metformin Pharmacogenomics: Biomarkers to Mechanisms

Pharmacogenomics is the study of the contribution of inheritance to variation in drug response—variation that can range from a loss of the desired therapeutic effect at one end of the spectrum to an adverse drug reaction at the other (1,2). The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) recently sponsored a workshop on the pharmacogenomics of metformin, the most widely prescribed drug for the treatment of type 2 diabetes. Metformin displays wide variation in efficacy and occasional serious adverse reactions (3). A report of that workshop is published in this issue (4). Pawlyk et al. (4) provide an overview of the current status of metformin pharmacogenomics as well as insight into the current state of pharmacogenomics as a discipline. Pharmacogenomic information is increasingly being implemented clinically and is being used to adjust drug dosage or to avoid adverse drug reactions (5). At the same time, pharmacogenomic research has moved from a focus on the contribution of genetics to variation in processes that we already understand—for example, drug metabolism and known drug target(s)—to also become a …