Pharmacogenetics Pharmacogenomics "Drug Testing"

[Michaelangelica]

Pharmacogenetics Pharmacogenomics

"Testing Drugs"

I am sure I/we had a thread on this before but now i can't find it.

I think this is a very important discovery and one that will have a profound effect on medicine and our health very soon.

Pharmacogenomics

The use of an individual's genetic profile to more accurately predict the safety, toxicity and efficacy of drugs - and ultimately to improve an individual's treatment and prognosis.

BioSpace - Gentris Corporation News, Search Jobs, Events

Pharmacogenetics is the study of the genetic basis of drug response.1 Pharmacogenomics is a term which is often used interchangeably, but refers to pharmacogenetics plus genomics and proteomics.2

The recognition that most human drug responses are multifactorial has led to the realisation that personalised medicine implies a broad consideration of factors and thus has resulted in the frequent use of the broader term pharmacogenomics.3

Hence, this article will follow the convention of using the term “pharmacogenomic (PGX) tests” for testing that influences drug response

.

Clinical Use of Pharmacogenomic Tests in 2009

 

 

Interindividual variability in xenobiotic metabolism and drug response is extensive. Genetic factors might be estimated to account for about 20-40 % of the interindividual differences in drug metabolism and response. Adverse drug reactions (ADRs) occur in 7 % of all hospitalised patients and fatal ADRs cause more than 100,000 deaths annually in the US.

http://ki.se/ki/jsp/polopoly.jsp?l=en&d=9785

 

Pharmacogenomics: One Size Does Not Fit All

 

A diagnostic test that can increase the clinical utility of a given therapeutic drug or procedure, while at the same time reducing the risks and costs associated with developing and marketing is a real synergy.

pharmacogenomics: the concept of combining a therapeutic intervention with a relevant diagnostic test.

Agenda — IIR

 

This article briefly reviews the evidence for the utilisation of pharmacogenomics for antidepressant drugs, tamoxifen, codeine, warfarin, azathioprine, clopidogrel, omeprazole, tacrolimus and irinotecan. There are few pharmacogenomics tests being carried out in practice, as there has not been a wide appreciation of their use, and only limited evidence exists for many individual drugs. It is expected that utilisation will increase as more evidence becomes available and there is a wider understanding of the existing evidence by the medical profession.

http://ukpmc.ac.uk/articlerender.cgi?accid=pmcA2702214&tool=pmcentrez

 

 

Table 2

Examples of drugs where evidence has shown PGX testing to be beneficial.

http://ukpmc.ac.uk/articlerender.cgi?artid=1777781&rendertype=table&id=t2-cbr_30_2_55

[Michaelangelica]

NEJM Discovers Applying Genomic Science to Drug Therapy

 

 

Pharmacogenetics has evolved over the past few years into pharmacogenomics, shifting focus from individual candidate genes to genome-wide association studies. The latest installment in our Genomic Medicine series,Genomics and Drug Response, reviews recent pharmacogenetic and pharmacogenomic advances, and discusses how such advances are reflected in drug labels. The authors aim to provide assurance that advances resulting from the application of genomic science to drug therapy may assist with drug selection and dosing, and reduce the odds of adverse drug reactions. Earlier articles in this series include Genomics and the Continuum of Cancer Care, Genomics, Type 2 Diabetes, and Obesity, Ancestry and Disease in the Age of Genomic Medicine, New Therapeutic Approaches to Mendelian Disorders, Genomewide Association Studies and Assessment of the Risk of Disease, Genomic Medicine — An Updated Primer

 

.

 

[Michaelangelica]

• Over half the drugs proved in BILLION dollar clinical trials are removed from the market within ten years because they don't work or kill people
• 1 in 5 visits to the GP here is for an ADR (a reaction to a drug given in the previous 4 vists)
• Over 100,000 Yanks die every year taking by prescription drugs as prescribed

[Michaelangelica]

http://the-scientist...lized-medicine/

 

The ghost of personalized medicine

 

Drug therapies tailored to the DNA profiles of individual patients could change the face of medicine, but such treatments aren’t commonly used in the clinic

 

By Bob Grant | June 14, 2011

Part of the problem, he suggested, is that physicians underestimate the predictive power of genetic risk factors for certain diseases or treatment outcomes. For example, he said that when he asks physicians in training to state the relative risks of classical predictors of heart disease, such as cigarette smoking or diabetes, he consistently hears figures like “10 to 15 times.” In fact, Vanier said, most of those predictors only have relative risks of around 1.8 to 2 fold, similar to some of the more robustly linked genetic markers of disease or drug effectiveness. If doctors are made aware of the fact that certain genetic biomarkers can be just as powerful as traditional predictors, they may be more inclined to use them to help personalize treatment regimes.