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Sep 1, 2009 (Vol. 29, No. 15)

Personalized Medicine Realizing Its Promise

As Evidence of Benefits Grows, Revision of Laws, Policy, Education, and Clinical Practices Is Needed

  • Make Drugs Safer

    According to a review of several studies, about 5.3% of hospital admissions are associated with adverse drug reactions (ADRs). Many ADRs are the result of variations in genes coding for the cytochrome P450 (CYP450) family of enzymes and other metabolizing enzymes. These variants may cause a drug to be metabolized more quickly or slowly than in the general population.

    As a result, some individuals may have trouble eliminating a drug from their bodies, leading in essence to an overdose as it accumulates, while others eliminate the drug before it has a chance to work. The consequences of not considering variation in these genes when dosing can range from futility to unpleasant or even fatal side effects.

  • Patient Compliance

    Patient noncompliance to treatment leads to adverse health effects and increased costs. When personalized therapies prove more effective or present fewer side effects, patients will be more likely to comply with their treatments. The greatest impact could be for the treatment of diseases such as asthma and diabetes, in which noncompliance commonly exacerbates the condition. At least one study supports this point.

    Inherited forms of hypercholesterolemia (high cholesterol) can increase the risk of myocardial infarction before the age of 40, more than 50-fold in men and 125-fold in women. Conventional monitoring of cholesterol levels can catch the condition early, but genetic testing offers additional benefits.

    In addition to detecting the condition before there are observable signs of disease, knowledge of a genetic predisposition for hypercholesterolemia provides patients with a powerful incentive to make lifestyle changes and to treat their condition seriously. Patients with a genetic diagnosis have shown more than 86% adherence to their treatment program after two years compared to 38% prior to testing.



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