Stratified (personalised) medicine
|Site:||EUPATI Open Classroom|
|Course:||Role of Pharmacogenetics / Pharmacogenomics in the Development of Medicines|
|Book:||Stratified (personalised) medicine|
|Printed by:||Guest user|
|Date:||Tuesday, 28 November 2023, 2:40 PM|
1. Same Symptoms, same disease, same treatment?
- Some will respond well.
- Some will respond, but less well.
- Some will not respond.
- Some may have serious side effects (adverse reactions).
- Some may develop ‘resistance’ to the medicine (they stop responding) - this can happen even if they responded well at first.
Doctors try to take into account various clinical and lifestyle factors when they treat individual patients. However, often the only option is to try out a treatment, and monitor the patient’s response. If necessary, the dose, schedule or medicine can be changed.
Today, we know that these patients are probably affected by ‘different’ diseases. In other words, patients can show the same symptoms but the symptoms can be caused by different processes in their cells (they have a different underlying pathology). These differences can have a great effect on how a disease will progress, and which is the best treatment.
This is an important change in the way to diagnose and treat disease.
2. New Understanding of Diseases
This section gives an overview of the research areas that are driving forward personalised medicine. More detail on specific technologies (such as ‘omics’) is given elsewhere in this training unit.
Personalised medicine requires that researchers develop more targeted medicines for a smaller patient group. These are likely to be used by fewer patients than ‘blockbuster’ medicines that treat more common diseases or conditions. The cost of developing a medicine is extremely high, so there has been concerns if the pharmaceutical industry can make targeted medicines profitable.
However, one advantage of targeted medicines is that they increase the efficiency of clinical trials. For example, if new medicines target a known cause of a disease, fewer medicines should fail at each stage of the development process. As explained earlier in this topic (section 3.3), the use of biomarkers is key to this work, and this is also explained in detail in the EUPATI biomarkers topic.
Armelle Corpet & Geneviève Almouzni. Science et Avenir. Dec 2006-Jan 2007