My lab is interested in all aspects of pharmacogenetics, from basic research to implementation in patient care. Pharmacogenetics refers to the effect of a person's genetic code on their response to a medication. How a person responds to or metabolizes a drug can vary widely in a population. As a trainee, I saw how genetics could help predict or explain some of this variability and wanted to make sure we continue to expand research in this area and use this information in clinical care. We study many different types of medications for many diseases.
One medication I am particularly interested in is methotrexate — used in high doses for treating cancer and low doses for treating autoimmune diseases. I convened and led an international group of experts in creating a consensus guideline for when to use glucarpidase, a medication used to prevent toxicity from methotrexate. We also developed a web tool that shows clinicians how an individual patient is predicted to eliminate methotrexate and whether they are likely to meet the indication criteria for glucarpidase.
We found that pharmacogenetic variants influenced the response, toxicity and dosing of antidepressants (sertraline, citalopram and escitalopram) in children. We then implemented clinical decision support with dosing guidelines through the Genetic Pharmacology Service to optimize dosing and potentially avoid side effects. The Genetic Pharmacology Service is a multidisciplinary team I work with to develop, interpret and implement new pharmacogenetic tests in the electronic medical record. I also educate doctors, pharmacists, genetic counselors and nurses on when and how to use the tests in the clinic.
I am a recipient of the Darrell Abernethy Early Stage Investigator Award (2019) from the American Society for Clinical Pharmacology & Therapeutics. I have more than 11 years of research experience and began working at Cincinnati Children's in 2015.