Genomics Tool to Access Genetic Profiles of Patients

Students in Purdue University’s (West Lafayette, Ind.) Department of Computer and Information Technology are working to develop an information-management tool that could give pharmacists instant access to patients’ genetic profile, making it possible to quickly determine the proper medicine dosage or if the drug cannot be tolerated by the patient.

“Toxicity due to a person’s genetic tolerance for certain drugs is the primary reason that prescription drugs are pulled off the market,” said Michael D. Kane, an assistant professor in the department and lead genomic scientist at Bindley Bioscience Center in Purdue’s Discovery Park. “Even though drugs are tested extensively, some people don’t metabolize drugs in the same way, leading to underdosing, or worse, overdosing and toxicity.

“There currently is no way for doctors and pharmacists to access and make sense of this information, so what we are doing could drastically improve patient safety and care in coming years.”

A patient’s genetic profile would be one factor in determining drug type and dosage, along with commonly used factors such as weight, gender, general health and interactions with other drugs the patient may be taking.

If a patient is prescribed a drug where an adverse response has been associated with a specific genetic makeup, the patient’s electronic health record would indicate that the patient is at risk for an adverse reaction. Kane said that in some cases certain patients may not be prescribed a drug at all or the dosage may need to be adjusted.

“Right now, the only way a person’s reaction to a drug can be determined is by starting them on a low dose, then adjusting and testing as needed,” he said. “If we can use genetics to make this known immediately, we can save a lot of time and money.”

Kane said students are using real clinical data to create a mock patient population that harbors genetic predispositions for altered drug metabolism. Using common database and software development tools, student-designed systems will be evaluated by practicing pharmacists, ultimately to provide training for fifth-year pharmacy students, practicing pharmacists and health-care professionals.

Although the practice of genetic screening across the population is not common now, technological developments and the medical benefits derived from having genetic information on file will likely make the process cheaper and more common, Kane said.

“Genetic testing relevant to pharmacogenetics is available now, but it costs hundreds of dollars per patient. And if you take that information to your doctor or pharmacist, they would have no idea what it means in terms of disease or drug metabolism,” he said. “That is why we are using real data to develop a system that is quick and easy to use and can translate this information for health-care professionals.”

Kane said the data that will be kept in such a database would be secure and would initially contain genetic information only as it relates to drug metabolism, not risk of disease, which is the basis of pharmacogenetics.

“Some people may be concerned about their having genetic information in a database, but what health-care professionals will have access to is not information on how likely a patient is to develop specific health disorders,” he said. “Having this genetic-drug interaction information available will actually benefit the patient, employer and insurance provider since overall health-care costs would be minimized by avoiding adverse drug reactions.”

Kane said taking genetic information into account when developing new drugs also would lead to a more efficient and specialized drug-development process.

“For instance, if a company makes a drug for a condition like schizophrenia, it may work on only a third of the population. If we have data based on genetic information, however, that company may be able to make three slightly different drugs, and nearly all of the population would be able to take one of them,” Kane said. “That would mean more profits for the company and more safety and less frustration for the patient.”

Kane said information about who can genetically tolerate certain medications is already included in the drug information literature available to doctors and pharmacists on some drugs, and he predicts it will be a widespread practice within a decade.

“Using genetic information in this way is a novel and exciting idea,” he said. “This really is the future of medicine. Our next step will be to focus on how to train health-care professionals.”

Kane is collaborating on this project with John A. Springer, an assistant professor of computer and information technology at Purdue, and Jon E. Sprague, dean of the College of Pharmacy and a professor at Ohio Northern University.

Release date: November 19, 2007
Source: Purdue University