Patients whose medication dosage is tailored to their DNA suffer 30% less from serious side effects. This is what a team of international researchers, led by the Leiden University Medical Center (LUMC), writes in The Lancet.
This is the first study worldwide to show that prescribing medicines based on a patient’s DNA profile works in practice.
Patients respond differently to the same drug
Of one-size-fits-allstrategy for prescribing medication is outdated. All patients respond differently to the same drug. The variation in our genetic information plays an important role in this. For example, one patient processes a drug faster than the other, and therefore needs a higher dose to achieve the same effect. A personal approach is therefore required.
DNA medication pass
Researchers have therefore developed a DNA medication pass that links a patient’s DNA profile to medicines whose processing is influenced by the DNA. By scanning this pass, doctors and pharmacists know exactly what the optimal dose is for the patient in question.
Standard dose vs custom dose
The study in The Lancet shows that patients who actively use this medication pass, and whose dosage is therefore adjusted to their DNA, report 30% fewer serious side effects than patients who are prescribed the standard dose.
In total, almost 7000 patients from 7 European countries participated in the study. The patients were spread over several specialties, including oncology, cardiology and psychiatry, but also, for example, general practice. They all had in common that they started with a drug whose processing is influenced by our genes.
First, the DNA of each patient was mapped. The researchers looked specifically at 12 genes. Together, the 50 different variants in these genes influence the effect of 39 medicines. Up to twelve weeks after the start, a nurse specialist contacted the patients to ask about their side effects. Think of diarrhea, anemia, nerve pain or loss of taste.
Patients with the DNA medication card not only experienced fewer side effects, they were also very happy with the card itself. According to the researchers, it gives them more control, because they are actively involved in their own treatment.
Standard care?
Henk-Jan Guchelaar, professor of Clinical Pharmacy at the LUMC, was the coordinator of this study. He has been researching so-called pharmacogenetics for over 20 years.
“We have now proven for the first time that this strategy works on a large scale in clinical practice. There is now enough evidence to proceed with implementation,” says Guchelaar.
“The next step is to put the DNA medication pass into practice,” added Jesse Swen, Professor of Clinical Pharmacy and principal investigator.
Devising these next steps also raises questions for the researchers. Should this pass be reimbursed? And have to be part of standard care? Guchelaar and Swen think so. According to them, this study has laid a good foundation for this.
“We want the DNA of every patient who comes to the pharmacy to be mapped,” says Guchelaar. “Only in this way can we make the treatment more effective and safer for every patient.”
This study was funded by a grant from the Horizon 2020 program of the European Commission (no. 668353).
The U-PGx consortium will be held by the LUMC in the following countries: Uppsala Universitet, University of Liverpool, Karolinska Institutet, Biologis, KNMP, UMC Utrecht, Golden Helix Foundation, Institute for Clinical Pharmacology in Stuttgart, Centro di Riferimento Oncologico Aviano, Medical University of Vienna, University of Patras, Junta de Andalucía, Université de Toulouse, University Hospital Aachen, Univerza v Ljubljani, Saarland University.