Pharmacogenetics
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What is Pharmacogenetics? - Every year in the USA alone 2 million people experience adverse drug effects and more than a 100,000 die from those reactions.
- Another horrible fact is that the drugs in today’s society are only effective in 60 % of the population. What can we do to stop these adverse drug effects? How can we develop drugs that can be effective for everyone? THE ANSWER IS PHARMACOGENETICS
Current Clinical Methods ₋ Nico Test for personalised regimen to quit smoking ₋ Amplichip for CYP 450 ₋ PCR based strategy for CYP 2D6 genotyping ₋ Tratuzumab: first drug with clinical application ₋ Thiopurines: immunomodulating drugs for leukemia and chronic inflammatory conditions ₋ Dosing considerations for other drugs such as Ironitecan, Warfarin, Tamoxifen, and Abacavir ₋ FDA has labelled 10% of its recently approved drugs with pharmacogenomic information
Ongoing Research on CYP
₋ Cytochrome P450 superfamily of enzymes
₋ Found all over the body but major enzymatic activity occurs in hepatic CYPs ₋ Bioactivation and metabolism of approximately 75% of drugs gives CYPs prominence in pharmacogenetics research ₋ Pharmacogenetic research is playing a major role in dosing of Warfarin (an anticoagulant)
Pharmacogenetics vs Bioethics Main ethical concerns are combination of the following: - Unequal distribution of benefits/resources - Invasion of medical privacy - Discrimination due to the involvementtof genetic tests - Research/business conflict-ofinterest
Major Drugs Ineffective For Many
…and harmful to some
Costs Impact Increase in costs - New Techniques need to be developed - Requires new training - Requires new facilities - Segmentation of market result in a reduction of revenue generated - Post marketing surveillance cost Benefits - Shelved drugs coming back to life. - Fewer legal liabilities. - Saving lives.
Thank you for your attention Group 13 Joe Hong Tanvir Kahlon Shereen Bart Linnéa Kadfors Traci Vogler Jennifer Duncan David Beshai
References • • •
• •
• • • • • • • •
•
Bioethics. (n.d.) In The Free Dictionary. Retrieved from http://www.thefreedictionary.com Barash, C.I. (2001). Ethical issues in pharmacogenetics. American Institute of Biological Sciences. Retrieved from http://www.actionbioscience.org/genomic/barash.html Genomics.energy.gov, Genome programs of the U.S Department of Energy Office of Science, Human Genome Project Information. (2008, September, 19). Pharmacogenomics. Retrived from http://www.ornl.gov/sci/techresources/Human_Genome/medicine/pharma.shtml Gettig, E. (2009). Personalized Medicine. Retrieved from http://mostgene.org/2009_conference/personalized_meds_Gettig.pdf Human Genome Project. (2008). Ethical, Legal, and Social Issues. Retrieved from http://www.ornl.gov/sci/techresources/Human_Genome/elsi/elsi.shtml Klug S. William & Cummings R. Michael & Spencer A. Charlotte. Essential of genetics 6th edition. Retrieved from page. 437. Lazarou, J., Pomeranz, B. H., Corey, P. N., (1998). Incidence of Adverse Drug Reactions in Hospitalized Patients. JAMA. 279. 1200-5 Murray, M. F. (2009). Will Plavix be the pharmacogenetics exemplar?. Retrieved from http://www.entrepreneur.com/tradejournals/article/202479739.html National Institute for Health and Clinical Excellence. (2009). Retrieved from http://www.nice.org.uk/ Nuffield Council on Bioethics. (2003). Pharmacogenetics Ethical Issues. Retrieved from http://nuffieldbioethics.org/go/ourwork/pharmacogenetics/introduction Ross, A., Pharmacogenetics cut clinical trial costs. Retrieved from http://www.ngpharma.com/article/The-genetic-advantage/ Stellenbosch University, Department of Biochemistry. (n.d). Ac Swart group (Image of cytochrome P450 oxidase). Retrieved from http://www0.sun.ac.za/biochem/Imagine/Media/Pictures/220px-CytP450Oxidase-1OG2.png University of Liverpool. (n.d). Pharmacogenetics (Image of DNA and pills). Retrieved from http://liv.ac.uk/pharmacogenetics/dna_and_pills.jpg White. M. T. (2000). Ethical Issues in Genetic Research. Retrieved from http://poynter.indiana.edu/sas/res/genetics.pdf
- Another horrible fact is that the drugs in today’s society are only effective in 60 % of the population. What can we do to stop these adverse drug effects? How can we develop drugs that can be effective for everyone? THE ANSWER IS PHARMACOGENETICS
Current Clinical Methods ₋ Nico Test for personalised regimen to quit smoking ₋ Amplichip for CYP 450 ₋ PCR based strategy for CYP 2D6 genotyping ₋ Tratuzumab: first drug with clinical application ₋ Thiopurines: immunomodulating drugs for leukemia and chronic inflammatory conditions ₋ Dosing considerations for other drugs such as Ironitecan, Warfarin, Tamoxifen, and Abacavir ₋ FDA has labelled 10% of its recently approved drugs with pharmacogenomic information
Ongoing Research on CYP
₋ Cytochrome P450 superfamily of enzymes
₋ Found all over the body but major enzymatic activity occurs in hepatic CYPs ₋ Bioactivation and metabolism of approximately 75% of drugs gives CYPs prominence in pharmacogenetics research ₋ Pharmacogenetic research is playing a major role in dosing of Warfarin (an anticoagulant)
Pharmacogenetics vs Bioethics Main ethical concerns are combination of the following: - Unequal distribution of benefits/resources - Invasion of medical privacy - Discrimination due to the involvementtof genetic tests - Research/business conflict-ofinterest
Major Drugs Ineffective For Many
…and harmful to some
Costs Impact Increase in costs - New Techniques need to be developed - Requires new training - Requires new facilities - Segmentation of market result in a reduction of revenue generated - Post marketing surveillance cost Benefits - Shelved drugs coming back to life. - Fewer legal liabilities. - Saving lives.
Thank you for your attention Group 13 Joe Hong Tanvir Kahlon Shereen Bart Linnéa Kadfors Traci Vogler Jennifer Duncan David Beshai
References • • •
• •
• • • • • • • •
•
Bioethics. (n.d.) In The Free Dictionary. Retrieved from http://www.thefreedictionary.com Barash, C.I. (2001). Ethical issues in pharmacogenetics. American Institute of Biological Sciences. Retrieved from http://www.actionbioscience.org/genomic/barash.html Genomics.energy.gov, Genome programs of the U.S Department of Energy Office of Science, Human Genome Project Information. (2008, September, 19). Pharmacogenomics. Retrived from http://www.ornl.gov/sci/techresources/Human_Genome/medicine/pharma.shtml Gettig, E. (2009). Personalized Medicine. Retrieved from http://mostgene.org/2009_conference/personalized_meds_Gettig.pdf Human Genome Project. (2008). Ethical, Legal, and Social Issues. Retrieved from http://www.ornl.gov/sci/techresources/Human_Genome/elsi/elsi.shtml Klug S. William & Cummings R. Michael & Spencer A. Charlotte. Essential of genetics 6th edition. Retrieved from page. 437. Lazarou, J., Pomeranz, B. H., Corey, P. N., (1998). Incidence of Adverse Drug Reactions in Hospitalized Patients. JAMA. 279. 1200-5 Murray, M. F. (2009). Will Plavix be the pharmacogenetics exemplar?. Retrieved from http://www.entrepreneur.com/tradejournals/article/202479739.html National Institute for Health and Clinical Excellence. (2009). Retrieved from http://www.nice.org.uk/ Nuffield Council on Bioethics. (2003). Pharmacogenetics Ethical Issues. Retrieved from http://nuffieldbioethics.org/go/ourwork/pharmacogenetics/introduction Ross, A., Pharmacogenetics cut clinical trial costs. Retrieved from http://www.ngpharma.com/article/The-genetic-advantage/ Stellenbosch University, Department of Biochemistry. (n.d). Ac Swart group (Image of cytochrome P450 oxidase). Retrieved from http://www0.sun.ac.za/biochem/Imagine/Media/Pictures/220px-CytP450Oxidase-1OG2.png University of Liverpool. (n.d). Pharmacogenetics (Image of DNA and pills). Retrieved from http://liv.ac.uk/pharmacogenetics/dna_and_pills.jpg White. M. T. (2000). Ethical Issues in Genetic Research. Retrieved from http://poynter.indiana.edu/sas/res/genetics.pdf
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