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DNA - Genetic Testing for Medication Tolerance

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njean

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I had something NEW happen to me at my cardiologist's office this week.

While waiting to see my doctor, another medical person walked in and asked me if he could take a DNA swab from me. I was of course puzzled and he went on to explain that this type test is being taken in many doctor's offices throughout the nation, particularly in cardiologist's offices.

He said that the DNA test reveals vital information to doctors of how a patient metabolizes a specific drug and allows them to determine the best drug and dosage for each patient. Blood thinners, beta-blockers, cholesterol and blood pressure meds are of particular interest.

He also went on to say that Medicare and many insurance companies are on-board with the screening because it will help cut costs both to the patient (co-pays), and your insurance.

With that said, I signed the document authorizing the test, and he swabbed the insides of my mouth for 30 sec on each side.

Has anyone else had this done at their doctor's office? What are your thoughts on it?
 

ottagal

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Wow, Njean,
Your doctor's office seems to be on the cutting edge! I personally had not had this test, but would be interested to know if anyone else has. I like the idea!
I did a quick google search and came across this article about it:
http://www.pennlive.com/bodyandmind/...y_deter_1.html

I would be interested to know if they make any medication changes for you based on your test results.

Stay well, :)
 

pellicle

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Hi

njean;n850626 said:
I had something NEW happen to me at my cardiologist's office this week.
...
He said that the DNA test reveals vital information to doctors of how a patient metabolizes a specific drug and allows them to determine the best drug and dosage for each patient.
...Has anyone else had this done at their doctor's office? What are your thoughts on it?
Really good news! Pharmacologists have know of this for some years (perhaps decades) and most online warfarin calculators include the gene information (if available) in determining your doses too

A journal article from 1997
http://www.ncbi.nlm.nih.gov/pubmed/9014207

and one discussing it in context of dosing from 2009
http://www.nejm.org/doi/full/10.1056/NEJMoa0809329

RESULTS
In the validation cohort, the pharmacogenetic algorithm accurately identified larger proportions of patients who required 21 mg of warfarin or less per week and of those who required 49 mg or more per week to achieve the target international normalized ratio than did the clinical algorithm (49.4% vs. 33.3%, P<0.001, among patients requiring ≤21 mg per week; and 24.8% vs. 7.2%, P<0.001, among those requiring ≥49 mg per week).
Yet curiously this important step has been neglected for a long time after its benefits were known. I'm really pleased to read that this is starting to make its way into the place where it should be ... the doctors office

:)

Excellent, really good outcome and certainly likely to bring better outcomes to patients
 

ottagal

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Pellicle,

Your response reminded me of an article I posted on VR.org in 2011 on "Genetics Guided Warfarin" testing in Canada. .

An excerpt: "The Personalized Medicine Clinic opened at LHSC's University Hospital in 2008. The clinic is the first of its type in Canada to adopt a genetics-guided personalized medicine approach as a part of care for patients on warfarin."

Here is the post: http://www.valvereplacement.org/for...netics-guided-individualiized-coumadin-dosing
 

pellicle

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For anyone interested here are some (perhaps complex) readings related to this on wikipedia

Firstly as has been reported here (grapefruit juice) an understanding of why it effects dose
http://en.wikipedia.org/wiki/CYP3A4#...ruit_ingestion

Then a list of drugs effected by this genetic variant of the cytochrome pathway
http://en.wikipedia.org/wiki/CYP3A4#...ruit_ingestion

This is an aspect of whatI have banged on about wrt warfarin dosage for a while now....

Thanks again for the good news njean.
 

njean

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ottagal;n850631 said:
Wow, Njean,
Your doctor's office seems to be on the cutting edge! I personally had not had this test, but would be interested to know if anyone else has. I like the idea!
I did a quick google search and came across this article about it:
http://www.pennlive.com/bodyandmind/...y_deter_1.html

I would be interested to know if they make any medication changes for you based on your test results.

Stay well, :)
Yes, I am quite excited about it too, Wanda and I believe it is a step in the right direction! Hopefully it will not only help in reducing costs but also assure patients that they are getting prescribed the best medications available for their particular issues. Some doctors are "prescription happy".....this will eliminate the guessing game, I think!

You take good care too and Merry Christmas to you and your family!
 
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njean

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pellicle;n850633 said:
Hi



Really good news! Pharmacologists have know of this for some years (perhaps decades) and most online warfarin calculators include the gene information (if available) in determining your doses too

A journal article from 1997
http://www.ncbi.nlm.nih.gov/pubmed/9014207

and one discussing it in context of dosing from 2009
http://www.nejm.org/doi/full/10.1056/NEJMoa0809329



Yet curiously this important step has been neglected for a long time after its benefits were known. I'm really pleased to read that this is starting to make its way into the place where it should be ... the doctors office

:)

Excellent, really good outcome and certainly likely to bring better outcomes to patients
Yes, I think it is good news for everyone and I think we should all be excited about it! Isn't technology great?! Thanks for posting some of the links available online.

Take care and Merry Christmas to you and yours!
 
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njean

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ottagal;n850631 said:
Wow, Njean,
Your doctor's office seems to be on the cutting edge! I personally had not had this test, but would be interested to know if anyone else has. I like the idea!
I did a quick google search and came across this article about it:
http://www.pennlive.com/bodyandmind/...y_deter_1.html

I would be interested to know if they make any medication changes for you based on your test results.

Stay well, :)
Thanks for the link!
 
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