Patients experience fewer side effects if medication doses are tailored to their DNA, according to a study published in the scientific journal The Lancet. This is the first practical application of DNA analysis to customise patient prescription drugs and promote personalised medicine.
The current one-size-fits-all approach often leads to problems with the effectiveness and safety of medicines. Every patient is different, and due to these genetic variations, patients respond differently to specific drugs. Some patients metabolise meds faster than others and, as a result, may need higher doses to have the same effect. In contrast, those who process slower may be more prone to side effects.
To avoid this, the team developed a DNA medication pass that connects the patient’s genetic profile and drugs that are influenced by DNA. The pass enables doctors and pharmacists to determine the optimal dose for each patient.
To produce the DNA pass, the team looked at 12 specific genes. For these genes, the team identified 50 types of genetic variants known to affect 39 drugs included in this study. When using the pass, patients experienced 30% fewer serious side effects compared to patients who received the standard dosage. About 7000 patients from seven European countries were included in this study across multiple disciplines, including oncology, cardiology, psychiatry, and general medicine. Side effects were assessed up to 12 weeks after treatment.
In addition, patients also expressed great satisfaction using the pass. It gave them the feeling of being more in control of their health and possibly becoming more involved in their personalised treatment. “This is a large landmark randomised study which shows that pharmacogenomic testing using a comprehensive genotyping panel can prevent adverse drug reactions, an outcome measure which is clinically important to individual patients and to healthcare systems. A 30% reduction in adverse reactions with a single intervention is remarkable. This is also consistent with the Personalised Prescribing report that was published by the Royal College of Physicians and British Pharmacological Society, which called for the implementation of pharmacogenomics into the NHS,” said Professor Sir Munir Pirmohamed from the University of Liverpool.
Implementing these DNA passes raises specific questions in each country, but the authors are keen to find a way to make them routinely used for all patients. “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,” says Henk-Jan Guchelaar, Professor of Clinical Pharmacy at Leiden University Medical Center. “By adapting implementation to suit each country’s healthcare system, we can make treatment more effective and safer for millions of patients.”
Swen J, Wouden C, Manson L, et al (2023) A 12-gene pharmacogenetic panel to prevent adverse drug reactions: an open-label, multicentre, controlled, cluster-randomised crossover implementation study. The Lancet, 401: 347-356. https://doi.org/10.1016/S0140-6736(22)01841-4