Genomics is starting to have a huge impact on pharmacy. It has been a factor for many years, with drug treatments targeting specific genetic variation leading its use. More recently, the focus has shifted to using genomics to predict how an individual will handle specific drugs to reduce harm and improve outcomes.
2021 saw the first nationally-driven pharmacogenomics implementation project. This used genetic testing to identify the 6.5% of patients who are at risk of toxicity from a particular group of chemotherapy drugs, known as fluoropyrimidines. Those patients have a low level of the enzyme (dihydropyrimidine dehydrogenase or DPD) which is required to prevent toxic accumulation of these drugs.
Genomics has the potential to significantly influence the way we use medicines, it’s really exciting.Paul Selby, Clinical Pharmacy Lead, East Genomics
He continued: "Almost everyone is predicted to have an atypical response to at least one drug and genomics can help to identify these".
East Genomics has completed a region-wide project which showed that the DPYD genetic test is now integrated in the routine standard of care, reducing preventable harm from systemic fluoropyrimidine chemotherapy in 30% of toxicity cases.
Integrating pharmacogenomic DPYD testing in routine NHS care paves the way towards accessible and routine personalised medicine, for hundreds of medicines. This will make a real difference to many patients.Aris Saoulidis, Senior Pharmacist (Transformation), East Genomics
Moving forward, increased genetic testing for components involved in pharmacological pathways will enable precision prescribing based on the mechanism of action of the drug to the body, and the way the body handles the drug, for each individual patient (see infographic).
All pharmacy staff are invited to engage further and join the network of practice via NHS futures (search East Genomics). You will need to register for this site if you don't already have access.
For more details email Paul Selby.