One in four taking mismatched drugs
New genomic data suggests widespread genetic variation impacts medication efficacy, though routine testing remains rare.
By Oliver Bennett ·
One in four people already taking a medication process it differently due to their genetics, according to a study published on November 12. The research indicates that standard prescriptions often fail to account for individual DNA variations, leading to side effects or reduced benefits for many patients. This finding challenges the current trial-and-error approach common in clinical prescribing.
The study analyzed whole genome sequences and health records from nearly 100,000 participants in the All of Us Research Program. This National Institutes of Health initiative aims to study more than one million people across the U.S. and its territories, with a specific focus on groups historically underrepresented in biomedical research. The goal was to broaden the diversity of pharmacogenomic data available to clinicians.
Researchers examined 16 genes with established links to medication response. They paired this genetic data with electronic health records to determine which drugs participants had previously taken. The team found that every participant carried at least one relevant genetic variant. Approximately 99.5% of participants had a variant for which the Food and Drug Administration or medical guidelines recommend a different drug or a dose adjustment.
The analysis identified 17,704 previously unreported variants in protein-coding regions of these genes. Computer models predicted that about a quarter of these variants may have substantial effects on drug processing. The team also reported frequencies for hundreds of genetic variants linked to drug response in populations with previously incomplete data. This new data helps address gaps caused by earlier research focusing primarily on people of European ancestry.
About 24% of participants had taken a drug affected by a genetic variant they carried. Common examples included omeprazole and pantoprazole for excess stomach acid, and statins for cholesterol. Because health records can be incomplete, the researchers noted that the actual prevalence of these gene-drug interactions is likely higher than the reported figures. The findings suggest that current databases used in research may need updating to reflect this wider range of genetic diversity.
The study does not prove that genetic testing improves outcomes for every individual. Other factors, such as age, kidney and liver function, and other medications, also influence how the body processes drugs. However, the data supports the potential for precision medicine to optimize prescriptions. The results come from a team led by Philip Empey, an associate professor at the University of Pittsburgh School of Pharmacy.
The All of Us Research Program continues to collect data to advance this field. The new findings are part of a growing body of evidence that DNA variation is common and relevant to treatment. Clinicians currently lack clear guidance on when to order genetic testing, but the study provides a more complete picture of genetic diversity in the U.S. population.
