Genetic testing study to boost medication response starts in Glasgow
The landmark trial will recruit up to 4,000 patients over the next two years in the NHS Greater Glasgow and Clyde area, to investigate how an individual's genetic profile affects their response to 60 common medications.
It is hoped the Phoenix Study will to lead to wider implementation of genetic testing across Scotland, making 'precision medicine' routine, for the first time.
Researchers hope it will pave the way for tailored prescribing across cardiology, stroke, surgery, orthopaedics, geriatrics, gynaecology, ENT, rheumatology, respiratory, neurology, psychiatry and other specialities.
The trial will take place at the Queen Elizabeth University Hospital (QEUH) in Glasgow.
Pharmacogenomics (PGx) – the study of how genes influence individual responses to drugs – has not been routinely used in clinical practice in the UK, amid hopes evidence will lead to change.
Genetic test results will be sent to clinicians, allowing for treatment decisions to be adjusted, and patients will be followed up regularly to monitor the effects of any changes, to ensure they receive the highest standard of care.
Patients will undergo a simple genetic test to analyse their DNA and the results, returned within days, will help doctors determine whether each patient is receiving the most suitable drug and dosage based on their genetic make-up.
Around 15% are expected to carry genetic variants that may reduce the effectiveness of a medication or increase the risk of side-effects.
In some cases, the prescribed drug may be ineffective, or a different dosage may be needed.
The trial is open to adult in-patients in the QEUH and patients will be randomly assigned to either receive the pharmacogenomic test immediately, or at three months, which will allow the researchers to establish evidence of benefit.
Without prior testing, these issues can go unnoticed, often leading to a trial-and-error approach to treatment, according to researchers.
It is led by Sandosh Padmanabhan, Pontecorvo chair of Pharmacogenomics at the University of Glasgow, in partnership with the University of Glasgow's Living Laboratory, the NHSGGC-hosted West of Scotland Innovation Hub, and industry partners MyDNA and Agena Bioscience.
Patient Eric Balish was asked to take part by consultants, after having a heart attack and subsequent surgery.
He was immediately prescribed clopidogrel, one of the 60 drugs included in the study, but has since had his medication changed a number of times.
Mr Balish said: 'I knew a bit about personalised medicine previously, and so when I was asked to take part in the Phoenix Study I was happy to do it.
'If you're asked to participate and support long-term research like this, then it's no great hardship to give something back and just do the right thing. I am hopeful my information can be of use to the trial and in the future.'
Prof Padmanabhan, a consultant at the QEUH, said: 'Physicians and pharmacists increasingly recognise that PGx-informed prescribing and dispensing improves both the efficacy and safety of drug treatment.
'The primary goal of this trial is to evaluate the clinical and health-economic impact of PGx-guided prescribing.
'Specifically, we want to determine if a PGx-guided approach to prescribing can significantly reduce the incidence and severity of drug related side-effects and/or treatment failures.
'This evaluation will compare the outcomes of participants who receive PGx-guided medication management to those receiving standard care.'
Dr Katriona Brooksbank, research and innovation lead for NHSGGC and the West of Scotland Innovation Hub, said: 'We are incredibly excited to be supporting this trial, which could have a major impact on the treatments patients are prescribed based on their own genetics.
'It will put precision medicine into action as researchers look to determine how a person's own genetic make-up can affect the drugs they are given as treatments.
'This could allow clinicians to reduce adverse reactions and side effects, ensuring the best possible outcomes for patients.'
Allan Sheffield, co-founder of MyDNA, said: 'For MyDNA, the Phoenix Study embodies the future of healthcare.
'Our unique combination of pharmacogenomic clinical decision support and in-house Gene by Gene accredited testing empowers clinicians to move beyond guesswork.
'This trial will demonstrate the profound impact of precision medicine, paving the way for a future where this approach routinely drives better patient outcomes.'
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