Sharpening the Interpretive Report

PGXL had a couple of posters up at the Association of American Pathology annual meeting. The team took a look at CYP2D6 and CYP2D7 hybridization, and noted a new CYP3A4 haplotype resulting in diminished drug metabolism. The results of those studies will be used to keep the PGXL interpretive report as sharp as possible.

DOWNLOAD “Allele Frequency of Two Previously Unreported Cytochrome P450 3A Haplotypes”

DOWNLOAD “A Practical Approach to Genotyping CYP2D6-CYP2D7 Hybrid Alleles Using TaqMan”

by Tom Johnson Tagged

Medically Necessary Pharmacogenetic Testing

We’ve put up a page of information about Medicare’s Local Coverage Determination (LCD) and its impact on reimbursement of pharmacogenetic tests. Medicare now considers it a “medical necessity” to conduct tests in certain circumstances. You can get detailed information HERE.

by Tom Johnson

Polypharmacy and Genetics: The Ugly Truth

The percentage of polypharmacy patients with genetic drug conflicts is stunning. PGXL is conducting a pilot study of software that reports drug-drug interactions along with genetic data. The fuller understanding of the patient’s condition and treatment options is proving incredibly valuable and popular with beta users. A full report will be published later this year, but there is preliminary data highlighting the complexity of the problem.

With the primary caveat that the 363 patients in the pilot program were selected by their physicians because their prescribed medications weren’t working as expected, PGXL found:

  • the average patient was on a dozen medications, four of which had a genetic link
  • 43% of the meds prescribed had a genetic conflict, including 30% with either a major conflict or outright contraindication
  • 38% of opioid patients had a CYP conflict
  • Among those taking SSRIs, 39% had a single gene conflict, and 44% had conflicts with both CYP and SLC6A4

The Polypharmacy Initiative estimates that nearly a third of elderly patients take 8 more prescription medications a day, and that up to 30% of hospital admissions among that population are traceable to drug problems.

by Tom Johnson Tagged , ,

Use of Genetic Information Increases Cancer Survival

The 2014 Cancer Progress report cites genetics as a key factor in cancer survival rates, causing a flurry of media attention.

Increasingly, patients suffering from cancers such as leukemia are being splintered into smaller groups based on the specific genetics of their malignancies, rather than where the disease occurs.

That has allowed researchers to pinpoint specific genetic mutations with new drugs, such as Spectrum Pharmaceuticals’s Beleodaq for lymphoma, approved by the Food and Drug Administration in July.

View the entire, 112 page report here.

To read a summary, click here.

The Cancer Progress Report website is here.

by Tom Johnson

Pain Management in Hospice Care

Midwestern home health and hospice provider ViaQuest is using the PGXL multi-drug diagnostic panel to add pharmacogenetic testing to their pain management program. Kathy Richard, ViaQuest’s chief clinical officer, describes the advantage:

“The current prescription method is guess work and often we are with patients who can’t communicate pain level. The genetic piece narrows it down for us to get the best dose.”

ViaQuest is tracking the effect a genetic understanding has on patient outcomes, and expects within three years to have data demonstrating the benefits of pharmacogenetics in pain management. Says Richard:

We hope that in the next 4 – 5 years, we are not the only hospice group doing this. The technology is available and a benefit to patients and families.

 

by Tom Johnson

Genetic Information Improves Pain Treatment

According to a report by the American Society of Interventional Pain Physicians, more than 100 million American suffer from persistent pain at an annual cost of around $600 billion. The skyrocketing use of pain medications is causing a corresponding increase in the number of medication-related crises, with more than 1.2 million opioid-caused emergency room visits a year.

The need for gene-based personalized medicine in pain treatment is most obvious to those who work on a day-to-day basis with patients. Speaking to the 2014 meeting of the American Association of Nurse Practitioners, Brett Badgley Snodgrass, MSN, APRN, FNP-C, of Comprehensive Primary Care in Bartlett, Tenn., said:

“Safe prescribing is of utmost importance, primarily to decrease diversion and abuse, but also to make it as safe and appropriate for our patients…Genomics can improve diagnostic and prescribing accuracy and speed. It’s helping with patients that are hard to treat – those in which no medications work, those that become very sedated with low doses of medication, those who are on high doses  that are still not getting appropriate effects with appropriate dosing.”

by Tom Johnson