Alaa Darwish of Wolters Kluwer, discusses the potential for pharmacogenomics to transform the efficacy of prescribed drugs.
One of the toughest challenges facing clinicians is which drugs to prescribe to their patients, and at what dosage. While most clinician/patient interactions end with a positive outcome, there are inevitably instances where treatment plans fail to achieve their objectives.
One emerging field that seeks to tackle this problem – and opens the door to a more a personalised approach to medicine – is pharmacogenomics. This is the study of how an individual’s genetic profile can influence the effectiveness or side-effect risk of a particular drug.
By targeting drug therapies to an individual’s genetic profile, health bodies in the GCC and across the world are seeing how they can improve outcomes and lower treatment costs. Pharmacogenomics replaces a ‘’one-size fits all’’ approach to medicine with a far more efficient model of individually targeted therapy.
Across a wide range of clinical disciplines, including cardiology, psychology and oncology, pharmacogenomics is potentially a game-changer. Following pioneering work in the U.S. and UK, pharmacogenomics is now quickly gaining ground in the GCC. For example, in Saudi Arabia, the Centre of Excellence in Genomic Medicine Research (CEGMR) at King Abdulaziz University, Jeddah, is conducting some of the world’s most advanced research into personalised medicine, including pharmacogenomics.
The pace of advances in the field is also increasing as more genetic variations that have a clinically important impact on drug choices are documented. To cite one example, there is now comprehensive data to show how the enzyme cytochrome P450 2C19 impacts on an individual’s ability to metabolise many widely-used drugs, including the antiplatelet drug clopidogrel. Clearly, a person’s genetic ability to ‘turn on’ a drug like clopidogrel may have serious implications for patients with acute coronary syndrome.
For clinicians, the challenge is to identify these important drug-gene interactions. Lexicomp – an internationally respected point-of-care drug information resource from Wolters Kluwer – is helping in this task by building genomics information into its internationally-respected drug reference resources, highlighting possibly important drug-gene pairings to clinicians in a clear, concise form, with actionable recommendations.
International working groups, like the US Food and Drug Administration (FDA), are encouraging the healthcare sector to embrace genomics. By providing guidance to drug companies on how to introduce biomarker information to their labelling, the FDA is helping legitimise the role of pharmacogenomics among the wider clinician community.
National initiatives, such as the 100,000 genomes project in the UK, the All of Us programme in the U.S., and The Saudi Human Genome Project, are also making it easier for the mainstream population to have their genomic data applied to medication decisions. Indeed, a recent report from Allied Market Research predicts that the global pharmacogenomics market will grow 8.6% from 2018 to 2025 – rising in value from $5.3 billion in 2017 to $10.2 billion by 2025 (almost double).
Of course, there are challenges ahead for the advancement of pharmacogenomics. The sheer scale of the task involved in building mass genomics data into national health systems is one. Genetic data privacy is another. And the risk of a twotier health system, in which only some have access to personalised medicine, is a further concern. However, there is no doubt that pharmacogenomics and personal medicine carry huge promise, not only in the treatment of society’s most prevalent diseases, but in making healthcare more efficient, targeted and effective.
Wolters Kluwer provides trusted clinical technology and evidence-based solutions that engage clinicians, patients, researchers and students in effective decision-making and outcomes across healthcare.
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