Pre-emptive pharmacogenomic testing could reduce drug side effects

Patients experienced 30 percent fewer serious side effects when their prescribed medication was tailored to their DNA profile by using a 'DNA medication pass'.

The benefits of personalised prescribing have been demonstrated for specific drugs, however, this study is the first to demonstrate the practical application of large-scale implementation of pharmacogenetic testing for a panel of drugs in a clinical setting.

'For the first time we have proven that a "tailored" strategy works at a large scale within clinical practice. There is now enough evidence for us to proceed with implementation,' said the lead author and coordinator of the study Henk-Jan Guchelaar, professor of clinical pharmacy at the Leiden University Medical Centre (LUMC) in the Netherlands.

In the study, published in The Lancet, researchers from LUMC developed a 'DNA medication pass' that associates a patient's genetic profile to their response to certain drugs.

The pass contains information based on 50 genetic variants in 12 specific genes that are known to affect how people respond to 39 different drugs used in general medicine as well as specialties such as oncology, cardiology and psychiatry. The idea is that scanning the pass enables doctors and pharmacists to know what the optimal medication dose is for the individual being treated.

Approximately 7000 patients from seven European countries tested the passes, which were created for each person based on their unique genome. All participants were prescribed at least one of the 39 drugs; half received the standard dose of the medication, and the other half had their dosage adjusted based on their DNA pass. Up to 12 weeks after treatment, patients were contacted by a nurse specialist to discuss if they had experienced any side effects.

The study found that patients whose treatment was tailored using the information on their pass experienced 30 percent fewer serious side effects than patients who were prescribed a standard dose of medication. The patients also reported feeling more in control when using the pass and became more actively involved in their personalised treatment.

The researchers hope that this DNA medication pass will become standard care, making medications more effective and safer for each patient.

'The results of this study further confirm the pivotal role pharmacogenomics can make to improve patient outcomes and will strengthen our ability to personalise prescribing across the UK and beyond,' said the principal UK researcher on the study, Professor Sir Munir Pirmohamed from the University of Liverpool.

'Adverse drug reactions from prescription drugs cost the NHS over £2 billion annually in hospital admissions. Ensuring prescribing is right the first time could help save the NHS money and resources,' he said.