Personal genetic analysis: This makes it clear which medications we tolerate individually and how well we tolerate them

Medicines do not work equally well for everyone. In the worst case, side effects or interactions occur when multiple medications are taken at the same time. The reason lies in pharmacogenetics: the way a person’s genes influence how they respond to drugs.

For example, about 90 percent of medications are broken down by various enzymes in the liver. However, these enzymes do not work equally well in all people: some people cannot break down the active ingredients at all, too quickly or too slowly. For example, if an enzyme is hyperactive, the active ingredients are broken down too quickly, preventing them from developing their effects. However, if an enzyme is too slow, the active ingredients can build up in the body and lead to side effects.

“If a headache tablet does not work, it is not particularly noticeable. In chronic diseases, such as heart disease, it is more problematic when medications do not work or cause long-term side effects,” says Wolfgang Schnitzel. He is the CEO of Pharmgenetix. The Austrian company uses pharmacogenetics to find out which drugs work optimally for a person.

Knowing how well the different enzymes work makes it easier to adjust dosages or use alternative preparations, says Schnitzel.

The genetic analysis is not a rapid test for home use. Patients discuss with their doctor whether it is useful to perform such an analysis. The doctor then orders the analysis box.

The results show via a calculation program which medication choice and dosage is best. Interactions between different medications are also taken into account. According to Pharmgenetix, the database is continuously updated and contains all common active ingredients in medicines.

Pharmgenetix is ​​not the only company offering this genetic analysis. Several laboratories in German-speaking countries offer a similar service, such as Stratipharm or the Swiss company Unilabs. What makes Pharmgenetix unique is the clear calculation program that allows even laypeople to gain insight into their genetic profile.

Henriette Meyer zu Schwabedissen, professor of biopharmacy at the University of Basel, also believes that the information provided by pharmacogenetics about the effects of medicines is good and valuable. It can be expected that the use of pharmacogenetic analyzes can also reduce healthcare costs in the long term.

However, she emphasizes that it would be wrong to pretend that genetics is the only reason why a drug works or is not tolerated. Various influences, such as diet, medications taken simultaneously, the underlying disease or the general constitution of the patient, also played a role in the effectiveness.

Schnitzel also confirms that genes are not the only decisive aspect in drug metabolism. Therefore, the results should be discussed with a doctor. He knows the patient’s medical history and can act accordingly. Schnitzel emphasizes that patients should not experiment with their medication on their own.

The company only works with doctors who understand the system. “We train every doctor who wants to work with us,” says Schnitzel. In Switzerland, the private clinic Hohenegg in Meilen near Zurich is a customer of Pharmgenetix. Genetic analysis is being considered for 5 to 10 percent of the approximately 650 patients per year, said Sebastian Haas, the deputy medical director of the special clinic for psychiatry and psychotherapy. However, not everyone wants to pay the 900 euros for it – because health insurers in Switzerland do not cover this analysis.

For the doctors in the clinic, the clear and user-friendly database is particularly valuable when providing advice on complex medication-related issues. Haas believes that the analysis has been proven to be effective. There is also another positive effect: “Placebo research shows that if patients and their outpatient follow-up care providers understand how the system works and are convinced of the medication, the therapy works better,” says Haas.

Pharmacogenetics is not the only way to find out how well a drug works. Doctors can determine this at least to a certain extent based on the blood values ​​- but only after taking the medicine – and therefore not to predict side effects. It can then be seen in the blood how high the concentration of an active substance is and from this it can be deduced how well a medicine is metabolized. (aargauerzeitung.ch)