A development that will interest many professionals seeking to optimise safe drug dosage calculations is the discovery by an international group of researchers that patients who have their medication doses matched to their DNA, experience a 30% reduction in side effects.

Led by Leiden University Medical Center (LUMC) in the Netherlands, the U-PGx consortium also includes such institutions as Uppsala Universitet in Sweden, the University of Liverpool in the UK, and InstitutfürKlinischePharmakologie in Stuttgart, Germany. Henk-Jan Guchelaar, Professor of Clinical Pharmacy at LUMC, coordinated the study.

What did the study find out about the matching of medication doses to DNA?

There are clearly issues with current “one-size-fits-all” approaches to prescribing medication; patients naturally vary in their genetic information, which means one patient’s response to a specific drug can often be quite different to someone else’s.

Some individuals, for example, process medication in a shorter space of time than others, which means that in order to achieve the necessary effect, they require a higher dose. Other patients, however, process medication more slowly, with an associated risk of side effects.

The researchers sought to devise an answer to this problem by developing a ‘DNA medication pass’, which links the genetic profile of a patient to drugs for which DNA influences processing. When this pass is scanned, doctors and pharmacists can learn what medication, and dose of that medication, would be optimal for the given patient.

It was discovered through this study – which was published in The Lancet – that patients who actively made use of the medication pass, and whose medication and doses were determined on the basis of their DNA, experienced 30% fewer serious side effects than individuals who were prescribed a standard medication dose.

The research involved the assessment of around 7,000 patients from seven European countries, encompassing a variety of medical specialities, including oncology, psychiatry, cardiology, and general medicine.

Some participants in the study were randomised to the genotyping arm, and had their DNA mapped. Up to 12 weeks following the start of treatment, patients were put in touch with a nurse specialist, who asked about any side effects they may have experienced, such as anaemia, diarrhoea, muscle pain, or nerve pain.

Patients who held the DNA medication pass didn’t merely experience fewer side effects; they also indicated a high level of satisfaction with the pass itself. The researchers said that the pass helped the patients to feel like they were in greater control, as they became actively involved in their personalised treatment.

Could the DNA medication pass now be incorporated into standard care?

With the group’s study being the first to demonstrate the practical application of using a panel of genes to customise medication prescriptions to the individual, the answer to this question would seem to be “yes”.

Prof Guchelaar said that “for the first time, we have proven that a ‘tailored’ strategy works at a large scale within clinical practice. There is now enough evidence for us to proceed with implementation.”

It is also important to acknowledge, however, that as steps are taken to figure out the implementation process, questions will arise that will be different in each country. “By adapting implementation to suit each country’s healthcare system,” Prof Guchelaar noted, “we can make treatment more effective and safer for millions of patients.”

Certainly, for stakeholders operating across every part of the medical research and healthcare sectors that have an interest in ensuring accurate and safe medication dosage calculations, the findings of this study are extremely important ones.

To date over 4.6 million safeMedicate drug dosage calculation assessments have been employed in the education of healthcare professionals across the globe. To learn more about the role that the safeMedicate team play in actively supporting students in the crafting and diagnostic assessment of competence, please feel free to contact us.