February 7, 2023 | James Kelley, MD, PhD - Chief Medical Officer, OneOme

I have an autoimmune condition and am currently taking seven prescription drugs. Over the years, I have suffered adverse drug reactions that have caused me more than just nausea, rashes, hospitalizations; there’s an emotional toll. I’ve been excited about how a medication will help me only to end up worse off. ADRs not only worsen clinical outcomes - they discourage patients who just want to feel better. 

There will always be risks when adding medications to our bodies, but we know we can reduce these.  Determining a patient’s genetic background (particularly for genes encoding liver enzymes that metabolize medications) is one way to understand how someone’s body responds to drugs, if toxic drug levels may build up, or if drugs break down before any benefit can occur. 

That is why this paper in The Lancet is particularly important.

1.) Their work, the PREPARE study, shows the value of pharmacogenomics in a large population spanning hospitals, outpatient clinics, and pharmacies across seven countries. By using genetic data in prescribing decisions in thousands of patients, the authors showed a 30% reduction in clinically relevant adverse drug reactions. That's a lot of suffering avoided from the use of a laboratory test. 

2.) This study highlights the benefits of pre-emptive, panel-based testing to guide medication decisions. Patients entering a care journey often have many medical issues to address. Genetic data are associated with response to hundreds of medications. Having upfront information can help personalize medication choices for conditions ranging from heartburn to depression to cancer.

3.) The PREPARE study demonstrated that successful implementation of large pharmacogenomic programs is possible. While data supporting genetic associations with drug metabolism is well established, the real challenge is getting patients tested and the information used by physicians.

Overall, this work adds to the growing appreciation that precision medicine can improve medication safety. If you are interested in learning more about how using genetics can help prevent adverse drug reactions in your patients (or for yourself), please contact me.

Read the study here.