The Role of Pharmacogenomics in Adverse Drug Reaction Prevention
27 December 2024
Adverse drug reactions (ADRs) pose a significant challenge in healthcare, leading to increased morbidity, mortality, and healthcare costs. However, the advent of pharmacogenomics has ushered in a new era of personalized medicine, allowing for the identification of individuals at risk of adverse drug reactions.
Understanding Adverse Drug Reactions
Adverse drug reactions or known as ADRs, can manifest in various forms, ranging from mild side effects to life-threatening conditions. These reactions are often influenced by individual genetic variations that affect drug metabolism, leading to variations in drug efficacy and safety among different patients. Research data show that adverse drug reactions (ADRs) are currently among the top six leading causes of death1 2.
Pharmacogenomics Unveiled
Pharmacogenomics involves the study of how an individual’s genetic makeup influences their response to drugs. By analyzing specific genetic markers, pharmacogenomic testing can reveal variations in drug metabolism pathways, drug targets, and potential side effect susceptibility. In the recent year 2023 European landmark publication (Lancet), patients were reported to experience 30% fewer serious side effects when undergoing pharmacogenomic-guided medication therapy3.
Identification of Genetic Variants
Pharmacogenomic testing identifies genetic variants associated with drug metabolism enzymes, such as cytochrome P450 enzymes, and other relevant genes involved in drug response. These variations can impact how quickly a drug is metabolized, its bioavailability, and its overall effectiveness in an individual’s body. Studies have shown that pharmacogenomics accounts for approximately 80% of the variation in drug efficacy and safety4.
Proactive Measures through Personalized Medication Strategies
Optimized Drug Selection
Pharmacogenomic testing allows healthcare providers to choose medications that align with an individual’s genetic profile, minimizing the risk of adverse reactions. For example, if a patient has a slow metabolizer phenotype for a particular drug, a lower dosage or an alternative medication with a different metabolic pathway may be recommended.
Dosage Adjustments
Tailoring drug dosages based on genetic information helps ensure that patients receive an optimal and safe amount of medication. This is particularly crucial for drugs with a narrow therapeutic index, where small changes in dosage can lead to adverse effects or inadequate therapeutic response.
Early Intervention
Identifying individuals at risk of adverse reactions allows for early intervention strategies. Healthcare providers can closely monitor patients, implement gradual dose titrations, or consider alternative therapies, reducing the likelihood of severe ADRs.
Preventing Medication Discontinuation
Some patients may discontinue medications due to intolerable side effects. Pharmacogenomic testing provides insights into potential adverse reactions, enabling healthcare providers to proactively address side effects and prevent premature discontinuation of essential medications.
Pharmacogenomics is proving to be a powerful tool in the prevention of adverse drug reactions. By deciphering an individual’s genetic code, healthcare providers can make informed decisions about drug selection, dosage adjustments, and early intervention strategies. As we move towards an era of personalized medicine, the integration of pharmacogenomics into clinical practice holds immense promise for improving patient outcomes and minimizing the impact of adverse drug reactions on public health.
Reference List
¹ Ganasegeran K, Rashid A. (2017) The prevalence of medication nonadherence in post-myocardial infarction survivors and its perceived barriers and psychological correlates: a cross-sectional study in a cardiac health facility in Malaysia. Patient Prefer Adherence. 8 (11):1975-1985.
² Ministry of Health Malaysia, World Health Organization. (2022) The Direct Healthcare Cost of Noncommunicable Disease in Malaysia.
³ Swen JJ, van der Wouden CH, Manson LE et al. (2023) Ubiquitous Pharmacogenomics Consortium. A 12-gene pharmacogenetic panel to prevent adverse drug reactions: an open-label, multicentre, controlled, cluster-randomised crossover implementation study. Lancet. 4;401(10374):347-356.
⁴ Cacabelos R, Cacabelos N, Carril JC. (2019). The role of pharmacogenomics in adverse drug reactions. Expert Rev Clin Pharmacol. 12(5):407-442.
