Journal of Pharmacy And Bioallied Sciences

LETTERS
Year
: 2016  |  Volume : 8  |  Issue : 1  |  Page : 77--78

Personalized medicine: A paradigm shift towards promising health care


Kalaivani Annadurai, Raja Danasekaran, Geetha Mani 
 Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Kancheepuram, Tamil Nadu, India

Correspondence Address:
Kalaivani Annadurai
Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Kancheepuram, Tamil Nadu
India




How to cite this article:
Annadurai K, Danasekaran R, Mani G. Personalized medicine: A paradigm shift towards promising health care.J Pharm Bioall Sci 2016;8:77-78


How to cite this URL:
Annadurai K, Danasekaran R, Mani G. Personalized medicine: A paradigm shift towards promising health care. J Pharm Bioall Sci [serial online] 2016 [cited 2019 Aug 21 ];8:77-78
Available from: http://www.jpbsonline.org/text.asp?2016/8/1/77/171732


Full Text



Sir,

Each individual is unique in their genetic structure and predisposition for diseases. Moreover, “one drug fit for all” approach leads to treatment failure or drug toxicity as evident from a report which states that 38% for antidepressants, 40% for asthma drugs, 43% for anti-diabetic drugs, 50% for anti-arthritis drugs, 70% for Alzheimer drugs, and 75% for anti-cancer drugs are the percentage of patients for whom a particular drug is ineffective.[1] Application of this concept paves the way for personalized medicine (otherwise called as precision medicine or stratified medicine).[2]

Personalized medicine refers to the customization of medical treatment according to the individual genetic characteristics of each patient. It doesn't mean the manufacturing of medicines that are unique to a patient. The concept is based on the classification of patients of a specific disease into sub-population depending on their genetic markers, susceptibility to a specific disease or response to a particular treatment. The ultimate goal is to maximize the therapeutic efficacy through rational dosage adjustment and to minimize the drug toxicity by optimal drug selection.[3]

Since genes plays an important role in the development of cancer, diabetes, cardiovascular disease, diseases of central nervous system, autoimmune disorders, behavioral disorders, certain infectious diseases, transplantation, prenatal, and pediatric diseases, personalized medicines said to play an immense role in those fields of medicines.[4] For initiation of personalized drugs, diagnostics are inevitable. As commonly called as companion diagnostics, they are the diagnostic tests that are used for identification of the patients who can be benefitted from precision medicines, detection of drug safety, dosing and monitoring the effectiveness of therapy after initiation. These tests will identify specific genetic markers for efficacy, safety, resistance, and dosing of drugs. The type of markers identified so far will be used to detect mutation drivers, response markers, drug metabolism markers, resistance markers, and drug safety markers.[5]

The cost of sequencing of the entire human genome dramatically reduced because of technical advance from US$10 million to a few thousand dollars over the period of 10 years.[6] In addition to genetic markers, it also uses in vivo diagnostics such as electroencephalogram, electrocardiogram, and positron emission tomography scan for response to certain drugs such as anesthetic agents, selective serotonin reuptake inhibitors and schizophrenic drugs as well as safety use of certain drugs. Also, there are diagnostics used for screening and risk identification.[5]

The advantages of personalized medicines are reduction of trial and error prescription, avoidance of adverse drug reaction, increase in patient adherence to treatment owing to less side effects, decrease in unnecessary prescription of drugs to nonresponder patients, optimization of drug development cost, helping in controlling overall health care cost, revival of once failed drugs for use in genetically defined population and improvement in the quality of life of the patients.[6],[7]

Translation of patient-tailored intervention into public health intervention, development of standards and guidelines for application of personalized medicines, need for adequate prognosis research in identification of all genetic markers as well as differential treatment response among different ethnic groups, availability of such diagnostic test at low cost both in developed as well as developing nations are the current challenges in the implementation of personalized medicines in general health services.[5],[6]

To conclude, personalized medicine is the use of the right drug, at the right dose at a right time. Recognizing the growing importance of the genomic revolution in the 21st century, incorporation of information on personalized medicine in the medical curriculum will be inevitable in the making of next generation physicians.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Spear BB, Heath-Chiozzi M, Huff J. Clinical application of pharmacogenetics. Trends Mol Med 2001;7:201-4.
2Government of Australia. National Health and Medical Research Council. Personalized Medicine and Genetics; 2013. Available from: https://www.nhmrc.gov.au/_files_nhmrc/file/your_health/genetics/g004_personalised_medicine_genetics_131120.pdf. [Last accessed on 2015 Jun 10].
3President's Council of Advisors on Science and Technology “Priorities for Personalized Medicine” September, 2008. Available from: https://www.whitehouse.gov/files/documents/ostp/PCAST/pcast_report_v2.pdf. [Last accessed on 2015 Jun 15].
4Mckinsey and Company. Personalized Medicine: The Path Forward; 2013. Available from: http://www.mckinsey.com/~/media/McKinsey/dotcom/client_service/Pharma%20and%20Medical%20Products/PMP%20NEW/PDFs/McKinsey%20on%20Personalized%20Medicine%20March%202013.ashx. [Last accessed on 2015 Jun 22].
5Kalush F. Personalized Medicine Past, Present and Future Challenges. University of Virginia, VA: MD-TIP II Workshop September 26, 2011.
6The Case for Personalized Medicine. 3rd ed. Washington, DC, USA: Personalized Medicine Coalition; 2011. Available from: http://www.personalizedmedicinecoalition.org. [Last accessed on 2015 Jun 19].
7Nair SR. Personalized medicine: Striding from genes to medicines. Perspect Clin Res 2010;1:146-50.