Pharmacogenetics has a head start on earning ergonomics credentials because it recognizes that one size does not fit all. In this new clinical discipline, announced by St. Jude Children’s Research Hospital in Memphis, two researchers are pioneering ways to use high-tech genetic testing to custom-make drugs to patients’ individual needs.
William E. Evans, Pharm.D., St. Jude Scientific director, and Mary V. Relling, Pharm.D., chair of St. Jude Pharmaceutical Sciences, are the co-investigators in the promising study, which was published initially in the May issue of Nature and more recently by the hospital.
It is controversial and not yet widely done, according to a recent article in The New York Times, and Dr. Relling travels the country advocating its use. “We’ve seen it save lives here,” she told the newspaper. “That’s made me a believer.”
Patients with leukemia are now routinely given genetic tests to determine their individual response to a medication. When hundreds of patients are given a drug, she explained, some will get no benefit, others will have terrible side effects, and still others will get benefits with tolerable side effects. Gene variants may be the cause. Until now, she said, there’s been a one-size-fits-all approach. In most cases, an average dose of a medication is ordered, and then, if the patient suffers side effects, the dosage is adjusted. With gene testing, we can customize the prescription.
She sees a lot of promise for pharmacogenetics in the treatment of arthritis, heart disease, colon cancer and even psychiatric diseases like depression and schizophrenia.
And pharmacogenetics promises to be cost effective. Dr. Relling explained that the genetic test is costly, but money can be saved at the clinical level. “With leukemia, we’ve seen that testing costs are minor compared to the savings gained by avoiding drug reactions, blood transfusions and additional hospitalizations.”
Sources: St. Jude’s Research Hospital; New York Times