What is Pharmacogenomics
(Farma-CO-Geen-Omics)?
Pharmacogenomics aims to predict how individual genetic variability impacts drug absorption,
metabolism and activity. While one treatment approach may work well for one individual, the
same approach may not be effective or may cause adverse drug effects in other
patients.
So What?
Pharmacogenomic Testing is rapidly becoming a new tool for doctors to optimize their patient’s medication therapy and efficacy while reducing the risk of side effects which may occur in certain patient population.
Who should be tested for PGx?
- Patients who are taking medications and/or initiating treatment with medication with FDA’s black box warnings that require/recommend PGx testing (1,2)
- Patients experiencing unexpected or exaggerated responses to medications (3)
- Patients who had a severe adverse drug reaction or complications due to ADEs (3,4)
- Patients who have experienced pharmacotherapy failure, as defined by having multiple unsuccessful drug trials (5,6,7)
- Patients who have demonstrated sensitivity or lack of symptom relief with recommended medication dosage (e.g. opioids for pain management) (6)
- Patients who require a higher- than- standard dosage to achieve the desired therapeutic result (2,6)
- Patients who have chronic conditions with multiple drugs (>5 by definition polypharmacy) prescribed to minimize drug-drug interactions, risk of adverse drug reaction, and potentially reduce the number of drugs prescribed (8,9,10)
- Patients who are diagnosed with new conditions with no previous pharmacological treatments that can be compared or evaluated (6)
- Doctors requiring an effective treatment and avoid the prolonged trial-and-error heuristic approach of medication prescribing (a classic example would be the strategy of selecting an antidepressant for depression management) (7,11)
- Arising conflicts in treatment strategy, medication selection and dosing in patients with grave and life-threatening conditions (ex. cancer patients) (3,8)
- Patients with a family history of a serious adverse drug reaction or known pharmacogenomic variant (12)
- Patients who have a history of poor medication compliance/adherence (7,12)
- Providers who needs guidance to select the right medication the first time based on individual’s genetic makeup (7,11,12,13)
- For healthy patients on no medications, who desires to take the PGx test preemptively so that results are readily available to immediately factored into the decision-making process prior to medication exposure (14)
PGx Testing
Invictus Pharmacy utilizes pharmacogenomics, which uses Cutting-Edge Biotechnology to
accurately predict how a patient’s body will respond to drug therapy based on
their individual genetic makeup.
Invictus Pharmacy works in collaboration with the patient and their HealthCare
provider.
- Empowers Physicians to make personalized treatment via medically
actionable and clinically
treatable data. - Reduce chance of Adverse Events upon initiation of new medication
therapy and allow for
potentially better adherence rates. - Obtain information on patient’s interactions between Drug-Drug,
Drug-Food, Drug-Alcohol,
Drug-Lab. - Access to Clinical Pharmacists which can assist in interpreting data and
recommending action
plan for each patient in compliance with patient’s Insurance Formulary. - Complimentary Support Service Including Insurance Reimbursement
Specialist and Medical
Affairs Clinician alleviates the guessing work for support staff. - Increase Patient Satisfaction and therapy success rate.
Patient Benefit:
- Familiarize themselves with what their body tolerates in respect to medications.
- Pain-Free Testing using Buccal swab or mouthwash to collect DNA from saliva.
- Experience less side effects from medications prescribe by their physician.
- Improve therapy goals and manage disease state with more confidence.
- Better Informed regarding which drugs to avoid for future treatments.
STATS:
- Overall incidence Rate of Adverse Drug Effects In United States: 6.7%3
- Associated Cost of these Adverse Effects: >$100 Billion4
- Hospitalization Rate of Patients Receiving Warfarin Therapy would Decrease 31% if patient received Pharmacogenomic Testing5
Step by step Process (animated and descriptive)
Which Patients Can Qualify?
Patients with Diseases/Illness in the following areas qualify for Genetic Testing:
- Anesthesiology
- ADHD (Attention-Deficit Hyperactivity Disorder)
- Cardiology
- Endocrinology
- Gynecology
- Gastroenterology
- Hematology
- Immunology/Rheumatology
- Infectious Disease
- Neurology
- Ophthalmology
- Oncology
- Pain Management
- Psychiatry
- PTSD (Post-Traumatic Stress Disorder)
- Respiratory
- Smoking Cessation
- Supplements/Complimentary & Alternative Medicine (CAM)
- Urology
- Weight Management
Drug List and Conditions:
The list provides the current most utilized drugs for which physicians request pharmacogenomic testing. The test is not limited to only these medications:
| Gene | Drug |
|---|---|
| HLA-B | Abacavir |
| HLA-B | Allopurinol |
| CYP2C19 | Amitriptyline |
| CYP2D6 | Amitriptyline |
| UGT1A1 | Atazanavir |
| TPMT | Azathioprine |
| DPYD | Capecitabine |
| HLA-A | Carbamazepine |
| HLA-B | Carbamazepine |
| CYP2C19 | Clopidogrel |
| CYP2D6 | Codeine |
| DPYD | Fluorouracil |
- Kitzmiller, J. P., Groen, D. K., Phelps, M. A. & Sadee, W. Pharmacogenomic testing: relevance in medical practice: why drugs work in some patients but not in others. Cleveland Clinic journal of medicine 78, 243-257, doi:10.3949/ccjm.78a.10145 (2011).
- Wang, L., McLeod, H. L. & Weinshilboum, R. M. Genomics and drug response. The New England journal of medicine 364, 1144-1153, doi:10.1056/NEJMra1010600 (2011).
- Samer, C. F., Lorenzini, K. I., Rollason, V., Daali, Y. & Desmeules, J. A. Applications of CYP450 testing in the clinical setting. Molecular diagnosis & therapy 17, 165-184, doi:10.1007/s40291-013-0028-5 (2013).
- Lazarou, J., Pomeranz, B. H. & Corey, P. N. Incidence of adverse drug reactions in hospitalized patients: a meta-analysis of prospective studies. JAMA: the journal of the American Medical Association 279, 1200-1205 (1998).
- Epstein, R. S. et al. Warfarin genotyping reduces hospitalization rates results from the MM-WES (Medco-Mayo Warfarin Effectiveness study). Journal of the American College of Cardiology 55, 2804-2812, doi:10.1016/j.jacc.2010.03.009 (2010).