Listen to this NPR piece on pharmacogenetics, which includes:
- case study of a boy reducing adverse events from Risperdal via drug metabolism testing
- other drugs mentioned include codeine, strattera, herceptin
- David Flockhart and Russ Altman are interviewed
The piece closes with this thought:
"Other experts, including Russ Altman of Stanford University, say
pharmacogenetics is such a new science that most doctors didn’t learn about it
in medical school. Clinicians have to find a laboratory that offers the test and
learn how to read the results, he says."
Toward this end, DNA Direct (my employer) has put the physician-writer Dr. Alan Eshleman on the case with the launch of a new blog on pharmacogenetics. He’ll be writing from the perspective of a physician that is not a pharmacogenetics expert, but is interested in learning about this new science and sharing his experiences with other physicians.
The blog is up and functional, but you’ll have to ignore the dust because we’re still working on layout/design.
Also, for information on drug metabolism, check out our website Genes & Drugs.
After a much needed break, I’m now back to blogging. As if keeping up one blog (err…plus 3 private bIogs and 2 wikis), I’ve also joined the ranks of another blog over at DNA Direct Talk where I’ll chime-in from time to time on business and technology issues in genetics.
My absence from blogging for the past 3 months is in part due to my involvement in the launch of a new pharmacogenetics service at DNA Direct, called Genes & Drugs. Check it out and let me know what you think:
For now, the site is an information resource on pharmacogenetics and drug metabolism. In addition to expanding the content, we will soon be offering testing services too. More to come on this…
MIT Technology Review interviewed David Flockhart of IUPUI recently. Here is a snip about the adoption of PGx testing:
TR: But the FDA has already approved a number of genetic tests to guide prescriptions. Aren’t doctors using them?
No…A major problem is
going to be educating physicians who are, as yet, relatively uneducated
about the availability of genetic tests to guide some of their
TR: How long will that take?
…The movement of these tests into the clinic will happen
gradually with fits and starts….Demand will kick in within a year or
two, as patients realize the power of these tests. That will be the
Erika Jonietz. Getting Personal about Drugs. Genetic tests are poised to revolutionize prescription writing. MIT Technology Review. March/April 2006.
David Flockhart’s website at IUPUI.
An article published in JAMA last week showed that coffee drinkers that are slow metabolizers of caffeine are at greater risk of heart attack. [Gulp] Caffeine is metaboized via an enzyme (CYP1A2) that lives in the liver. Genetic polymorphisms of this enzyme are common. Some people metabolize caffeine more quickly or slowly than others, related to which version of the CYP1A2 gene they have. [Gulp]
The slow metabolizer variant (CYP1A2*1F, nomenclature here) is quite common, at least in Costa Rica where the study was undertaken–54% of the population were carriers of *1F allele. [Gulp]
I’m currently drinking is
approximately the size
of a small dog.
Figure: The cup of coffee
Cornelis MC, El-Sohemy A, Kabagambe EK, Campos H. Coffee, CYP1A2 genotype, and risk of myocardial infarction. JAMA. 2006 Mar 8;295(10):1135-41.
University of Toronto Department of Nutritional Sciences
Russ Altman, Opportunities for Pharmacogenomics and Personalized Medicine. Google Video, February 22, 2006.
Russ Altman bio
From the press release:
Hosted by the International Society of Pharmacogenomics, the
Pharmacogenomics E-Symposium will be held live & online on 12
Opening Keynote: Allen Roses, GlaxoSmithKline
Live Presentations and Round table debates on:
-Pharmacogenomics : Delivery to patients and patient acceptance
-Prescribing by ethnicity
-What is the role of pharmacogenomics in our approaches to substance abuse?
-The role of Pharmacogenomics as a laboratory tool in diagnostics and therapeutics
-Toxicogenomics - Is the Problem the Toxin or the Genome?
-Pharmacogenomics of Psychiatry
-Pharmacogenomics of Neurological Disorders
Closing Keynote: Urs Meyer, Biozentrum, University of Basel
Check out the Pharmacogenomics E-Symposium website.
Roche has posted a video describing their Amplichip CYP450 test, a DNA microarray that can identify 2D6 and 2C19 gene variants.
SCOTTISH doctors are building a unique gene database that will match
medicines to individual patients, boosting the chances of effective
treatment while reducing side-effects.
Researchers are planning to collect genetic information on 320,000 patients from blood samples taken at GPs’ surgeries.
The team at Ninewells Hospital in Dundee will use the data to
unravel the genetic mysteries behind the varied reactions different
people have to the same medicine.
By examining the DNA of patients who suffer side-effects from a
drug, or are responsive to it, they will pinpoint the genes responsible
for the variations.
This will allow doctors to give patients a course of treatment closely tailored to their genetic make-up…
[Dr Alex Doney, a consultant vascular physician at Ninewells, and leader of the project] said: "The idea is to use genetics as an extension of a
person’s medical record, in the same way as cholesterol, blood pressure
and blood sugar levels."
Doney and his team are planning to collect genetic information from
patients in Tayside by using ‘spare blood’ left over after tests on
He hopes the project will act as a pilot for similar pharmacogenetic databases in Scotland.
He said: "Normally the blood left over from blood samples would be
discarded, but we want to keep it and link it with patients’ medical
records. We estimate about 80% of the 398,000 people in Tayside will
visit their doctors over the next 10 years to have a blood test."
Richard Gray, "Coming soon: drugs to match your DNA" Scotsman. April 24, 2005.
Ninewells Hospital, Dundee
Price Waterhouse Coopers. Personalized Medicine: The Emerging Pharmacogenomics Revolution. February 2005.
Pharmacogenomics promises to help physicians tailor drug regimens to a patient’s genetic profile. A recent event at Vanderbilt serves as a useful reminder that despite our best efforts to improve drug efficacy and to reduce the number and severity of toxic reactions to drugs with all kinds of fancy tools like pharmacogenomics, there is a swarm of flies threatening to muck up the ointment. How about a citrus soda?
David Melzer, Ann Raven, Don E Detmer, Tom Ling, Ron L Zimmern. My Very Own Medicine: What Must I Know? Information Policy for Pharmacogenetics. University of Cambride. Funded by the Wellcome Trust. July 2003. (summary pdf or full pdf)