MEDICINE


let’s get


personal


AS NI wElCOmES ITS NEw CENTRE fOR PERSONAlISED mEDICINE, PIf lOOkS AT hOw ThE PROVINCE’S ClINICIANS ARE lEADINg ThE wAy IN ONE Of ThE fASTEST gROwINg AREAS Of RESEARCh: ONE ThAT IS SET TO ChANgE ThE wAy wE RESPOND TO IllNESSES…


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ave you heard about the new antibiotics that contain an edible sensor? Once a patient


takes their pill, the sensor feeds relevant information - when the patient is taking it, their heart rate etc - and feeds it back to the gP, who can then deduce why the medication is or isn’t working for that particular patient.


Think it sounds far-fetched? far from it. The sensor, which is currently being trialled at the karolinska Institute in Stockholm, is just one example of what is known as personalised medicine - also known as precision or stratified medicine - which uses genomics to diagnose and manage patients’ health and devise targeted therapies to treat their illnesses.


In 90 per cent of prescribed drugs, up to 30-50 per cent of patients won’t


22 - PhARmACy IN fOCUS


respond or - even worse - will experience an adverse reaction. (It’s estimated that one in fifteen hospital admissions in the Uk are linked to adverse drug reactions.) The cost to the patient in terms of worry and stress is one thing, but when you consider that, in 2011, of the £595bn global spend on medicines, almost £400bn was spent on therapies, which did not produce the desired effect, then you can imagine the cost to the NhS.


The concept of personalised medicine is not new. Clinicians have been working to personalise care, tailored to people’s individual health needs, throughout the history of medicine. But never before has it been possible to predict how each of our bodies will respond to specific interventions, or identify which of us is at risk of developing an illness. New possibilities are now


emerging as we bring together novel approaches, such as whole genome sequencing, data and informatics, and wearable technology.


By combining and analysing information about our genome, with clinical and diagnostic information and then comparing that with data from others, patterns can be identified.


In 2000, the first draft of the human genome sequence was announced, which gave clues about what individual differences might mean for our health. This sequence came, however, at a cost of over £2 billion for a single sequence.


Over the course of the past two decades, and thanks to new sequencing technology, there has been a dramatic drop in the cost which, coupled with the availability


of high-speed computing needed for analysis, this type of technology is now possible as part of routine healthcare.


So, how does it work? well, personalised or stratified medicine is based on the concept of whole genome sequencing, which involves looking at a person’s entire DNA, rather than looking at specific genes or groups of genes. when this sequencing is analysed in conjunction with other information about the individual, it provides clinicians with an overall ‘blueprint’ of an individual’s make-up and allows them to target specific therapies to that person.


where, traditionally, medicine has been built around clinical teams specialising in a particular organ system working back from a patient’s symptoms to arrive at a diagnosis, personalised medicine turns this


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