Say you get diagnosed with cancer. Your doctor gets you a blood test, sends the results in, and before long, you get back a sheet that tells you exactly what drugs will best fight the disease - essentially giving you a roadmap toward curing your illness. Sounds like Gattaca stuff: sending in your genome to get back a reading as to exactly how drugs will interact with your system? Well, it still is science fiction - for now.
Recent research from The International Warfarin Pharmacogenetics Consortium, published in the Feb. 19 issue of the New England Journal of Medicine with contributions from the University of Florida, detailed how genetic information led scientists to better prescribe accurate and effective doses of an anticoagulant. It has been known for quite some time that background genetic variability plays a key role in dose determination for most drugs, but this study has finally acquired the statistical data needed to support the conclusion that this genetic approach to drug prescription and interaction may be a realistic possibility, and for more than just anticoagulants.
Anticoagulants are a far cry from cancer-busting prescriptions, but the technology used to determine the correct dose - genomic collection, analysis and compatibility screenings with drugs - are clear first steps toward more far-reaching applications.
The drug in question in the survey is the very widely-prescribed anticoagulant Warfarin. It was first used in high doses as a pesticide, but physicians noted that, under proper dosage, it was very safe for humans and did wonders in preventing thrombosis and embolisms. Now, it is the most commonly used anticoagulant drug; it is used to treat blood clots by thinning the blood (preventing coagulation) and for therapy after atrial fibrillation, heart valve replacements, and even heart attacks.
The only problem with Warfarin is that it's a highly sensitive anticoagulant; push the dose too high, and what was helping before is now hurting you. There is a reason it was used as a pesticide first; if the blood is thinned too much, it could cause uncontrollable bleeding, like in anemia, and other serious side effects. "Warfarin is a complicated drug to use because of its very narrow therapeutic window," Julie A. Johnson, who directs the University of Florida Center for Pharmacogenomics, said. "This is one of the top five drugs that cause hospitalizations for adverse effects."
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