GENE-BASED DRUG PRESCRIBING COULD BENEFIT VIRTUALLY ALL ALABAMIANS
Gene-Based Drug Prescribing Could Benefit Virtually All Alabamians
Based on analysis of 3,386 participants in the Alabama Genomic Health Initiative ( AGHI ), a paper published in Clinical and Translational Science in June by researchers at UAB and the HudsonAlpha Institute of Biotechnology in Huntsville says that “ almost all Alabamians harbor at least one actionable genotype that can impact current or future medications , and a significant proportion are currently prescribed affected medications .”
The researchers found that 98.6 % of those studied had actionable gene variants as designated by the Clinical Pharmacogenetics Implementation Consortium . “ Pharmacogenomics really has the potential to benefit everyone ,” says Brittney Davis , PharmD , instructor in the Department of Neurology and first author on the article “ Evaluation of population-level pharmacogenetic actionability in Alabama ” and an instructor in the Department of Neurology ’ s Program for Translational Pharmacogenomics . Pharmacogenomics is the study of how gene variation affects people ’ s response to medications .
The UAB-developed AGHI is one of the nation ’ s first statewide efforts to harness the power of genomic analysis in helping identify those who are at risk for diseases caused by genomic abnormalities . It has enrolled more than 7,000 participants from all 67 Alabama counties since launching in 2017 . Participants receive genomic testing , interpretation , and counseling free of charge . “ AGHI is designed to advance scientific understanding of the role that genes play in health and disease ,” says Bruce Korf , M . D ., Ph . D ., associate dean for Genomic Medicine , UAB Chief Genomics Officer and AGHI ’ s principal investigator .
The researchers also noted that “ the prevalence of actionable genotypes by gene differed significantly by race .” These racial differences were particularly notable in participants prescribed the beta blockers atenolol , carvedilol , and metoprolol , commonly used to manage heart failure . Overall , about 50 % of participants studied had an actionable variant in the ADRB1 gene , which is associated with decreased therapeutic response to beta blockers . For Black participants , that rate was 62.5 %, while it was 47.4 % for white participants .
Unlike many studies , the AGHI cohort includes a racially diverse population , with 18 % of participants self-reporting as Black . “ Here we show that pharmacogenetics is actionable for all Alabamians , independent of their race ,” says Nita Limdi , PharmD , Ph . D ., director of UAB ’ s Program for Translational Pharmacogenomics and co-principal investigator for AGHI .
Korf says the AGHI is now entering a new phase , which he calls AGHI ( 2.0 ), that “ will focus on enrollment in primary care clinics in an effort to integrate genomics in routine medical care ,” he says . In addition to reports on genetic disease risk , participants and their health care providers now are receiving pharmacogenomic information , which will be included in the participants ’ electronic medical records ( EMR ).
“ This is where the action is in precision medicine ,” says Limdi . “ We are laying the foundation on how to integrate genomic medicine in clinical care . Pharmacogenomics is poised to affect both individuals and the population at large .” – Matt Windsor
Courtesy of UAB News / Design by Kate Green
10 Alabama Genomic Health Initiative Annual Report 2021