by James Gallagher
We have the technology to start a new era in medicine by precisely
matching drugs to people's genetic code, a major report says.
Some drugs are
completely ineffective or become deadly because of subtle
differences in how our bodies function.
Pharmacological Society and the Royal College of Physicians
say a genetic test can predict how well drugs work in your body.
The tests could be available on the
NHS next year.
or DNA is an instruction manual for how your body
operates. The field of matching drugs to your DNA is known as
It would have helped Jane Burns, from Liverpool, who lost
two-thirds of her skin when she reacted badly to a new epilepsy
She was put on to
carbamazepine when she was 19.
Two weeks later, she developed a rash and her parents took her
to A&E when she had a raging fever and began hallucinating.
The skin damage started
the next morning.
Jane told the BBC:
"I remember waking up
and I was just covered in blisters, it was like something out of
a horror film, it was like I'd been on fire."
Jane Burns, now 50,
has to be careful in the sun and
is "terrified" of taking new medicines.
Her epilepsy medicine caused
Stevens-Johnson syndrome, which
affects the skin and is far more likely to happen in people who are
born with specific mutations in their genetic code.
Mrs Burns says she was "extremely, extremely lucky" and said she
supports pharmacogenomic tests.
"If it saves your
life, then it's a fantastic thing."
everyone is affected
Jane's experience may sound rare, but Prof
Mark Caulfield, the
'president-elect' of the
British Pharmacological Society,
"99.5% of us have at
least one change in our genome that, if we come across the wrong
medicine, it will either not work or it will actually cause
More than five
million people in the UK get no pain relief from codeine.
Their genetic code does not contain the instructions for
making the enzyme that breaks codeine down into morphine and
without it, the drug's a dud.
The genetic code
of one in 500 people puts them at higher risk of losing
their hearing if they take antibiotic gentamicin
is already used for some medicines.
In the past, 5-7% of
people would have a bad reaction to the HIV drug
abacavir and some died. Testing
people's DNA before prescribing the drug means the risk is now zero.
Scientists have looked at the 100 most prescribed drugs in the UK.
Their report says we
already have the technology to roll out genetic testing to guide
the use of 40 of them.
The genetic analysis would cost about £100 and could be done
using either a sample of blood or saliva.
Initially, the vision is
to perform the test when one of the 40 drugs is prescribed.
In the long term, the
ambition is to test well ahead of time - possibly at birth if
genetic testing of newborns goes ahead, or as part of a routine
check-up in your 50s.
"We need to move away
from 'one drug and one dose fits all' to a more personalized
approach, where patients are given the right drug at the right
dose to improve the effectiveness and safety of medicines," said
Munir Pirmohamed, from the
University of Liverpool.
"What we're doing is really going to a new era of medicine,
because we're all individuals and we all vary in the way we
respond to drugs."
He said that as we age
and are prescribed more and more drugs, there's a 70% chance that by
the age of 70 you will be on at least one drug that is influenced by
your genetic make-up.
David Prior, the chairman of
NHS England, said:
"is the future" and
"it can now help us to deliver a new, modern personalized
healthcare system fit for 2022"...