New genetic testing program launched to provide personalized therapy plans

Written by Rosanna Hill, Future Science Group
General interest News

Patients recovering from cardiac stent surgery are offered individualized therapy plans based on their genetics.

Owing to a new genetic testing program, doctors at the University of Maryland Medical Center (UMMC) and Baltimore VA Medical Center (MD, USA), both affiliated to the University of Maryland, are now able to prescribe individualized long-term therapy to patients recovering from cardiac stent surgery. Patients undergoing cardiac stent surgery can now benefit from individualized therapy plans thanks to the Personalized and Genomic Medicine Program at the University of Maryland Medical School. The program allows patients to be tested for CYP2C19 gene variants, a gene linked to faulty metabolism of some anti-platelet medicines prescribed after cardiac stent surgery, and subsequently offered the most suitable medication according to their genetics.

A pharmacogenomics study carried out by Alan Shuldiner, Director of the Personalized and Genomic Medicine Program, in 2009 observed that patients with the faulty CYP2C19 variant exhibited faulty metabolism of clopidogrel (Plavix®), the routine medicine administered (with aspirin) to patients after cardiac stent surgery. Following these results, the US FDA issued a report warning patients of the reduced efficacy of clopidogrel in patients with the faulty gene.

The genetic testing of patients is extremely efficient: the patients’ DNA is isolated from a blood sample and analyzed at a new state-of-the-art translational genomics laboratory at the University of Maryland School of Medicine. Due to the partnership between the University of Maryland and the two medical centers, results are back within just a few hours. Patients with the faulty CYP2C19 gene are offered either an increased dose of clopidogrel with aspirin or alternatively other medicines, which have other limitations, such as prasugrel (Effient®) and ticagrelor (Brillinta®).

“Pharmacogenetic testing enables us to tailor drug treatments to individual patients based on their unique genetic makeup, or genotype,” says Shuldiner, “With genotype-directed therapy, we have the ability to change the ‘one size fits all’ approach to prescribing medication and ultimately improve the quality of care we provide to our patients. Patients want personalized and individualized medicine. They seek it out.”

The Personalized and Genomic Medicine Program was established in April 2011 and is jointly funded by the UMMC and University of Maryland School of Medicine. The genetic testing is currently NIH funded (and, therefore, free to patients) at the UMMC and in five other big US hospitals in a pledge to determine the most successful methods of providing a genetic testing program to deliver personalized medicine.

Shuldiner and his team plan to continue and expand this initiative to provide personalized therapy for patients taking warfarin, simvastatin and codeine.

Source: University of Maryland Medical Center launches genetic-testing program for cardiac stent patients.