Pharmacogenomics
Every year as many as 100,000 patients in US hospitals die as the result of adverse drug reactions. How many of those deaths could be avoided if we knew in advance which drugs were safe and which weren' t for those particular patients? And beyond those dire cases, how much more effectively could we treat sick people if we knew what variants in their genomes made certain drugs more effective than others for them? Welcome to the rapidly developing field of pharmacogenetics (or, as it is increasingly known, pharmacogenomics). Its mission is to examine the genomes of patients and use that information to prescribe the right drugs at the right dose.
At Duke, investigators in the newly created Center for Population Genomics & Pharmacogenetics and the Center for Genomic Medicine are involved in an ongoing quest to identify genomic factors that control drug response in individuals and populations. Recent work suggests that, under current regimens, many epilepsy patients with specific genetic variants may not be receiving the correct dosages of certain anti-seizure medications.
Not only do these investigators hope to deliver the right drug to the right patient at the right dose, but they also expect that by understanding the ways in which genes mediate drug response, they will come to understand the molecular basis of disease. Their reasoning is that if one knows which biochemical pathways drugs act upon (as demonstrated by variations in genes coding for proteins in those pathways), it should be possible to target those pathways for further research and intervention. Pharmacogenomics promises to allow us to use existing drugs in a more rational way, and to develop new drugs that are safer and more effective.