Pharmacogenomics- The future of medicine

"What makes us human, and what makes each of us his or her own human, is not simply the genes that we have buried into our base pairs, but how our cells, in dialogue with our environment, feed back to our DNA, changing the way we read ourselves. Life is a dialectic.”

- Jonah Lehrer.

Pharmacogenomics is the study of how genes affect a person’s response to drugs. This relatively new field combines pharmacology (the science of drugs) and genomics (the study of genes and their functions) to develop effective, safe medications and doses that will be tailored to a person’s genetic makeup.

Today's therapy focuses on medicines that focus on a disease or a symptom. The science of pharmacology is based on the study of a disease, its symptoms and the different ways by which the disease/symptoms can be alleviated.

This often leads to the mistake of trial and error prescriptions, patients developing drug tolerance and the often-committed error of symptom control rather than cure of the disease.

The advantages of the pharmacogenomics approach is that the treatment(s) could be tailored to a group of patients or to individual patients.

The various factors that could be taken into consideration in treatment with a pharmacogenomic approach would be -

1. The metabolism of the patients

2. Drug sensitivities

3. Treating patients with unique genetic disorders including autoimmune diseases

4. Identifying optimal dosing for individual patients rather than a one dose for all approach.

5. Various drug interactions.

6. Age related reaction to drugs.

The pharmacogenomic approach is of paramount importance when it comes to treating challenging conditions like HIV and cancer where the treatment modality needs to change from time to time.

An argument often heard against this approach is that it is not cost effective to develop such a medication regimen. Also, specialists in the field often opine that there is insufficient data that support use of the pharmacogenomic approach in daily practice. However, with the advance of computational techniques in pharmacogenomics, we can safely say that we are quickly heading towards a system of individualized medicine. Also, there need to be more studies on the safety and risks of such tailored medication regimens.

The USFDA, in 2013, released its guide Clinical Pharmacogenomics (PGx): Premarket Evaluation in Early-Phase Clinical Studies and Recommendations for Labeling, addressing the use of genetic information in drug development and regulatory review.

For this approach to work better, researchers and businesses need to work to work together to establish a model where a better understanding of underlying genomic factors will result in newer drugs and treatment regimens that are targeted at addressing the underlying issue.

However, more studies are needed to establish this as a specialty and to make it a part of our day to day life.