Imagine if efficacy and safety issues with medications could be overcome with a simple test. Drugs have the potential to improve and save lives, but there’s no one-size-fits-all. A drug may work well for some patients but not for others and may even be harmful to other patients.
Why pharmacogenomics will change the way we treat patients
Pharmacogenomics (pronounced ‘FAR-muh-co-jen-NO-mix’) is changing the face of medicine by giving clinicians insights into a patient’s genetic profile and how that can influence efficacy and safety when taking a prescribed drug. Pharmacogenomics is the study of a person’s genetic profile as it relates to a response to medications. This information is a potential game-changer for clinicians, giving them quick insight into which drugs are likely to be effective or ineffective for a patient as well as dosing levels and specific side effects.
Advances in genomics and in the study of genetic variation have accelerated in recent years, vastly improving the potential for pharmacogenomics and personalized medicine. With detailed analyses of more than 150 drug-gene pairings1 available to clinicians, pharmacogenomics is no longer confined to labs and symposiums, but is instead already having a real-world impact on patients. Clinicians now have far more information about drug-gene pairings, an invaluable source when prescribing drugs to patients. For example, the enzyme cytochrome P450 2C19 (CYP2C19) affects a person’s ability to metabolize many commonly prescribed drugs, such as clopidogrel, a blood thinner used to prevent stroke, heart attack, and other heart problems. Studies have shown that patients who carry a variant form of the gene CYP2C19 have an increased risk of serious cardiovascular events when prescribed clopidogrel before balloon angioplasty or stent placement.
Pharmacogenomics has the potential to transform the approach to prescribing across all therapeutic categories. Focus is likely to turn to several widely used medications, such as steroids used to combat inflammation. Pharmacogenomic tests to assess the response to inhaled corticosteroids for asthma have been carried out with hopes that it will be easier to determine drug response with the aim of improving outcomes and reducing adverse events. Genetic information also can determine dosage. For example, some people (with one or two copies of CYP2C9 variant alleles) require a lower dose of warfarin to prevent potentially fatal bleeding.
One area that may benefit hugely from pharmacogenomics is Alzheimer’s disease, a condition that is projected to have a global cost to society of $20.8 trillion between 2015-2050. Researchers believe genomic factors may be the key to advancing the development of drugs that may finally prove more effective in treating the disease.