A new pharmacy research project aims to prescribe personalized medicine to patients.
The Genomics for Precision Drug Therapy in the Community Pharmacy project will sequence patients' DNA to determine medication selection and dosage. Research will be conducted at UBC's faculty of pharmaceutical sciences.
“The aim is to try and use a person's DNA to make decisions about the most frequently prescribed drugs,” said Cindy Chen, pharmacist at Heart Pharmacy in Victoria, one of the 22 pharmacies across B.C. involved in collecting patients' DNA for the study.
“We've been talking about personalizing medicine for so long, [and] I think we can begin to put this into practice,” said Corey Nislow, professor in the department of pharmaceutical sciences at UBC. “Your genome and DNA sequence influences so many aspects of your life and your health and illness, that there's many different ways to use this information to tackle different health challenges.”
For the pilot project, the focus is on warfarin, a commonly-used anti-coagulant drug.
“It's one of those drugs we start everyone on a standardized dose. But for the majority of people, this dose has to be adjusted multiple times over the course of the therapy,” said Chen. “When we sequence a person's DNA, there is a site on there that tells us how they will actually be affected by the warfarin drug. By knowing this information, we'll be able to give them exactly the right dose to start with and not mess around.”
Pharmacists at the 22 pharmacies will recruit a total of 200 patients who are currently taking warfarin to be part of the study and collect saliva samples to be sent to the lab at UBC.
“We're going to decode the sequence of all 20,000 genes in every patient's genome.” said Nislow.
He said he hopes the pilot project takes 12 months or less. Then, researchers will be able to expand the research to look at the 150 other drugs for which DNA is known to impact a patient's response.
“The first drug will take the most time, because that's where we're decoding your DNA. We're indexing that DNA, and for the next drug, it literally will be as simple as typing the second drug and doing a query on the information,” said Nislow.
The information on each person's DNA is secure and confidential, said Nislow.
“The name and demographic information is separated from the actual DNA sequence information. So I see a sample in a tube with a barcode. I don't see a name.”
Patients involved in the pilot project will not get any information back about their DNA. It is purely for research purposes.
The current cost to sequence a person's DNA is $1500 and takes two weeks, said Nislow, adding he expects the time and cost to continue to go down.
“The pace of technology development in DNA sequencing has been astounding.”
The budget for the pilot project is $400,000 and is funded by the B.C. Pharmacy Association and Genome B.C. Research.
Nisolw said he expects to be able to put this personalized medication into practice within three years.
“We have to start bending the cost curve in health care, and one way to do that is to stop giving people drugs that can't benefit them, and get them on the right dose faster.”