Moving gene-based therapies from bench to bedside

Pharmacogenomics is a major component of precision medicine, which aims to give the right drug to the right patient at the correct dose. Therapies based on patients’ genetics hold a great promise to improve healthcare, while simultaneously reducing medical expenses.

A team from the United Arab Emirates University (UAEU), in collaboration with researchers from the University of Patras, Greece, has analyzed pharmacogenomics initiatives worldwide and highlighted strategies to overcome the obstacles that prevent the successful integration of pharmacogenomics into clinical practice.

Over the last decades, it has become clear that variations in genes encoding proteins for drug transport and metabolism can affect drug distribution in the body and lead to under or overdosing. Beyond the clinical advantages of lowering toxicity and improving patients’ quality of life, pharmacogenomics reduces visits of patients presenting drug-induced adverse effects and lowers healthcare costs.

It is a challenging transition. To determine effective medications and doses, physicians or pharmacists must have access to the genetic test results of their patients. They also need tools and training to incorporate pharmacogenomics into their workflow, while prioritizing the confidentiality and privacy of patients’ genetic data. Assessing global efforts, the team found that the most successful studies had been conducted in the US or Europe, that the implementation efforts in Asia are still in their infancy, and that there is a complete lack of such measures in Africa.

“The most important outcome of our review is that pharmacogenomics implementation in clinical practice is feasible. We believe that the success stories from other countries are indispensable for implementation efforts in the UAE,” says Zeina Al-Mahayri, postdoctoral fellow researcher at the Department of Genetics and Genomics, College of Medicine and Health Sciences, who worked with UAEU’s Bassam R. Ali to write the review study.

UAEU researchers are currently developing the country's first point-of-care pharmacogenomics approach. Funded by the UAE Ministry of Education, this project’s overarching ambition is to personalize drug treatment for cardiovascular diseases, the leading cause of death in the country. The team has carried out pharmacogenomics studies to characterize the genetic variability in the Emirati population in key pharmacogenes—genes involved in drug response. In particular, they have looked at VKORC1, which affects the response to the blood thinner warfarin, and cytochrome P-450 genes, which encode essential drug-metabolizing enzymes.

The team plans to measure adverse events, cost-effectiveness and patients’ quality of life. They also want to increase awareness about pharmacogenomics among the population and healthcare providers, which is essential for the future uptake of precision medicine.