Question: One of my patients is having negative reactions to medication. I’m interested in trying the DNA test to better understand the patients response to current medication in addition to predicting his response to medication I’m considering. What are the steps and how can the results be used?
Answer: Our genetic makeup is unique and responses to medications can vary. Some can metabolize certain medications and gain a therapeutic effect while others experience adverse reactions. Pharmacogentics will allow you to determine if the medications currently being prescribed are the most effective in that particular drug class. The report will alert you to any medications the patient is sensitive to and will suggest a reduced dosage and/or alternative medications that can result in more effective treatment. It will also highlight any medications the patient has an altered response to and may suggest increasing the dosage for best response.
The steps are straight forward and begin with a cheek swab to collect cells from the patient, similar to the process of paternity DNA samples. A genetic profile of the patient is determined by the DNA sample. The profile is measured against some 120 to 150 medications and actionable evidence is provided based on the metabolizing enzymes with known polymorphisms (SNPs). As an example, the report might highlight a risk with taking Zocor and suggest you consider Lipitor or Mevacor as better options for a given patient.
The patient is better served as the most effective medications can be determined on the first attempt rather than prescribing a medication followed by a 30 day progress review to evaluate the response. The patient also saves healthcare dollars by avoiding the trial and error approach. We know what the medication can do; now we can predict the patients response to it.
Driving this trend are the 106,000 deaths and more than 2 Million serious events caused by adverse drug reactions in the US each year. Adverse drug reactions are responsible for 5-7% of hospital admissions in the US and Europe and lead to the withdrawal of 4% of new drugs. Increased safety, improved effectiveness and reduced healthcare expenses are benefits we can achieve when we combine DNA and Drugs.