The future of personalised medicine begins in Leiden
Researchers at Leiden University Medical Center received a 15 million EU-grant for pharmacogenomics: the study of personalised medicine based on a patient's DNA.
“Drug therapy can be much more effective if we take the patient’s DNA into account,” says Henk-Jan Guchelaar, professor of Clinical Pharmacy at LUMC.
As of January 2016 LUMC will be leading a huge pharmacogenomics project conducted in seven European countries. The project will result in more efficacious, safer and cost-effective drug therapy.
Pharmacogenomics is the study of how genes affect a person's response to drugs. “Drug therapy can be much more effective if we take the patient’s DNA into account”, says Henk-Jan Guchelaar, professor of Clinical Pharmacy at LUMC. “Clinical guidelines tell doctors to prescribe a certain preferred drug. But you’ll never know if it really works or not. The patient takes the drug, comes back for a check-up after some weeks, and gets another dose or even another drug if the prescribed one doesn’t seem to be effective. Or if the side effects turn out to be too strong. It’s a question of trial and error.”
Personalised medicine might change this for the better. If scientists specify type and dose of drugs in order to fit the patient’s genotype more precisely, drug therapy will be more efficacious, safer and cost-effective. Over the years a huge body of knowledge on interactions between genes and drugs has been built up, explains Jesse Swen, member of Guchelaar’s research group. “The Netherlands have always been in pole position when it comes to scientific and clinical knowledge in pharmacogenomics. Leiden can be proud of gaining this grant from the EU-program Horizon 2020, which will enable us to make important steps towards personalised medicine.”
“Our study will follow 8,000 patients in seven European countries, which will lead to applicable knowledge on who to test pre-emptively.”
Despite the major advances in pharmacogenomics (PGx) and several commercially available PGx tests, its application in routine patient care remains very limited, Guchelaar stresses. “In The Netherlands we already implemented knowledge on risky gene-drug combinations into the drug database which is used by prescribers and pharmacists. An alert message will pop up when a drug is ordered or dispensed for a patient with an at-risk genotype. The next step would be to broaden the system with pre-emptive screening.” Swen elaborates: “ Right now a gene test is only done when a patient shows an unusual reaction on a certain drug. We will build a model of personalised medicine through pre-emptive PGx-testing. Our study will follow 8,000 patients in seven European countries, which will lead to applicable knowledge on who to test pre-emptively.”
With the pre-emptive PGx testing approach, data on multiple important pharmacogenes are collected prospectively and will be embedded into the patient's’ electronic record. And then, according to Guchelaar, the biggest challenge is yet to come: to assure implementation in routine patient care, taking into account the diversity of healthcare systems and citizens across Europe. “If the project succeeds, it will definitely result in better outcomes for patients.”
Jesse Swen, Associate Professor of Pharmacogenetics
The U-PGx will run in Spain, UK, Italy, Austria, Greece, Slovenia and The Netherlands. More information on http://upgx.eu
LUMC starts master in pharmacy
The Dutch Ministry of Education has agreed upon a new master’s program in pharmacy, with students entering by the start of September 2016. Leiden might become one of the focal points of Dutch pharmacology, says professor Guchelaar. “The master program will enable us to educate a new generation of pharmacists who will combine patient care on a scientific basis with the latest knowledge on personalised medicine. It is a major step towards linking science and clinical practice.”
More information on the new pharmacy master
Interview by Marc van Bijsterveldt
Photo's by LUMC
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