In this week's BMJ, Wolf from the ICRF Pharmacology Unit at Ninewells Hospital, Dundee, and Smith from the Imperial College School of Medicine, review the rapid progress of pharmacogenetics - the prescription of drugs according to an individual's genetically determined response to them.
The authors discuss how pharmacogenetic testing will substantially cut hospital treatment for adverse drug reactions, currently thought to account for one in every 15 admissions. Although not widespread in the UK, pharmacogenetic testing is being used in some teaching hospitals and academic centres and has been used in Scandinavia for some time. At the moment, it is most widely used to help tailor drugs and doses for the treatment of psychiatric illness, but is also being developed for cancer treatments.
The ability to predict genetic variability in drug response has been facilitated by non-invasive DNA tests which require only a small sample of tissue, such as blood from a finger prick or cells from a mouth wash, together with a better understanding of the way in which drugs work, say the authors. Although they caution that we are some way off from a DNA chip that General Practitioners could use to identify a total drug sensitivity profile for each patient, pharmacogenetics should enable the design of new drugs that are safer and more effective for particular groups of people. "One day it may be considered unethical not to carry out such tests routinely to avoid exposing individuals to doses of drugs that could be harmful to them," they conclude.
Professor Roland Wolf, Imperial Cancer Research Fund Molecular Pharmacology Unit, Ninewells Hospital and Medical School, Dundee Email: email@example.com
Professor Robert Smith, Imperial College School of Medicine, London c/o Hotel Armada, Istanbul