In the first of three plenary sessions, Dr Alun McCarthy (UK drug development and genetics, Glaxo Wellcome) and Dr Jon Johannes Jonsson (department of clinical biochemistry, University of Iceland) addressed "new horizons" in patient care and therapeutics.
Pharmacogenetics had the potential for removing much of the uncertainty in predicting an individual's response to a medicine, said Dr McCarthy. It was now possible to profile many polymorphic variants of an individual's genome using SNP (single nucleotide polymorphism) mapping. This technology could be used to find disease genes and to correlate a patient's genetic information with his or her probable response to a medicine.
Selection of patients with increased likelihood of response would make clinical studies smaller, more efficient, faster and less costly, suggested Dr McCarthy. He added that many more drugs could be tested, including those that might be highly effective in only a small proportion of patients.
Dr McCarthy recognised that there would be concern that adverse events might be missed if studies were to become more streamlined but the inclusion of non responders in trials just to evaluate the incidence of adverse events would be ethically questionable. He said that currently most adverse events were picked up through voluntary reporting following the marketing of a new medicine. If pharmacogenetics was used to identify responders then these patients could be closely monitored, resulting in a comprehensive response profile for efficacy and adverse drug reactions.
Replying to a question about identifying responders in practice, Dr McCarthy agreed that, whilst appreciating the science, pharmaceutical companies must be aware of the practicalities of using the technology. A decision about whether or not to prescribe a particular drug needed to be made promptly and at the moment the infrastructure was not in place to allow for immediate genetic testing.
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Alun McCarthy: technology could be used to find disease genes
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