December 6, 2016

Pharmacogenomics: the Rx for success

By Susan Buckles

pgx-photoPatients would save time, money and untold suffering if they proactively have DNA testing to match medications to their individual genetic profiles, writes Konstantinos Lazaridis, M.D., assistant director of Mayo Clinic Center for Individualized Medicine. It is likely not  uncommon for patients with a chronic medical condition to be on what he calls a “therapeutic odyssey” in which they try medication after medication for years without getting any relief .  Dr. Lazaridis’ editorial, Improving Therapeutic Odyssey: Preemptive Pharmacogenomics Utility in Patient Care  appears in the October 23, 2016 publication of The Journal of Clinical Pharmacology & Therapeutics.

“Therapeutic odyssey represents a protracted journey in a patient’s quest to find effective therapy for a chronic disease, often leading to unsuccessful treatments, frequent visits to healthcare providers, poly-pharmacy, herbal or alternative medicine-based therapy options and sometimes unwanted symptoms – or even adverse drug events” says Dr. Lazaridis.

Dr. Konstantinos Lazaridis

Dr. Konstantinos Lazaridis

The practice of using a person’s genetic profile to help prescribe the right treatment at the right dose is known as pharmacogenomics. Dr. Lazaridis says now is the time for health care providers to proactively recommend pharmacogenomics testing for all patients and enter the results in the electronic health record, noting:

  • The RIGHT Study, done at Mayo Clinic, found that 99 percent of all patients studied had a genetic variant that impacts the way the body processes medications.
  • Traditionally, dosages are prescribed based on clinical trials performed in the general population, which does not take into account an individual’s genetic variation.
  • A one-size-fits-all approach doesn’t take into account individual genetic variations that could cause medications not to work as intended or could cause painful side effects.
  • The Centers for Disease Control, in a study published in Journal of the American Medical Association (JAMA), reports one out of every 250 Americans visited the emergency room because of a harmful drug reaction in both 2013 and 2014.

“The emerging field of preemptive pharmacogenomics in clinical practice holds an enormous promise to improve the medical care of our patients,” says Dr. Lazaridis.

In today’s busy health care environment, Dr. Lazaridis notes, most providers don’t have time to ask patients how each medication is working for a specific chronic disease or whether they are having painful side effects. Consequently, they may not be getting the best treatment or may develop adverse drug reactions. For example, a 31-year-old woman’s medication to control obsessive-compulsive disorder didn’t seem to work. In addition, for 10 years, she suffered fatigue, panic attacks, palpitations, numbness and tingling sensations. The patient indicated it was ruining the quality of her life. Pharmacogenomics testing showed genetic variants were making current therapy ineffective and causing these painful side effects. As a result, her doctors prescribed new alternative therapies that are more compatible with her genetic profile, better control the disease symptoms and minimize side effects.

Dr. Lazaridis contends that pharmacogenomics testing must become a standard practice in order to improve safety and quality of care. He says doctors, pharmacists, nurses and educators must all work together to adopt practices that make it possible for all patients to benefit from the individual-tailored treatments that pharmacogenomics offers.

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Tags: #Center for Individualized Mediicne, #Genetic test results, #PrecisionMedicine, #RIGHT 10K study, DNA Testing, Dr. Konstantinos Lazaridis, mayo clinic, PGx, pharmacogenomics, Uncategorized

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