PJ Online | News: Adverse events may be predicted by pharmacogenomics

The Pharmaceutical Journal Vol 267 No 7175 p733-738
24 November 2001

Adverse events may be predicted by pharmacogenomics

Drug therapy based on the genetic make-up of individuals might result in a clinically important reduction in adverse events, researchers suggest.

Dr Kathryn Phillips, department of clinical pharmacy, University of California, San Francisco, and colleagues investigated the potential role of pharmacogenomics in reducing the incidence of adverse drug reactions (ADRs). They conducted two literature reviews: one for studies reporting ADRs and the other for studies reporting genetic variation in drug-metabolising enzymes. The results of the two reviews were then linked.

The researchers found that 59 per cent of drugs cited in the ADR studies are metabolised by at least one enzyme where one of its genetic variants is known to cause poor metabolism.

Among a group of randomly selected drugs, this figure was 22 per cent, and among a random selection of best-selling drugs in the United States, this figure was just 7 per cent.

"These results suggest that genetic variability in drug metabolising enzymes is likely to be an important constributor to the incidence of ADRs," the researchers say.

They comment that although the application of pharmacogenomics has great potential, it also faces substantial hazards. These include the fact that clinical practice is not yet ready for the application of pharmacogenomics and that many genetic variations are correlated with race which could potentially lead to questions over stereotyping and preferential treatment.

However, looking ahead, the authors conclude: "In the future, we may all carry a gene chip assay report that contains our unique genetic profile that would be consulted before drugs are prescribed." (JAMA 2001;286:2270.)