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AmpliChip for Personalized Prescriptions

November 30th, 2006 Nicholas Genes Medicine

dont mix with grapefruitEmily Singer, a journalist who is a Medgadget favorite for her cutting-edge stories at MIT’s Technology Review, gets personal this week when she writes about the promise of pharacogenomics — individualized pharmacology based on one’s genetic makeup (she and her family frequently suffer debilitating side effects from commonly prescribed meds).
The first product that may help doctors dispense drugs wiser is the AmpliChip assay:

…a new product, marketed by the Swiss pharmaceutical giant Roche and approved by the U.S. Food and Drug Administration in January 2005, now has the potential to begin making pharmacogenomics broadly accessible. Called the AmpliChip CYP450 assay, it uses genetic analyses to ascertain how quickly people metabolize certain drugs, thus predicting who is most likely to experience unpleasant or even toxic side effects.
When two people take the same dose of a drug, their bodies may metabolize it so differently that the amount of it that can act on its target varies tremendously. Some people may have an especially efficient form of an enzyme that breaks down a drug; others may have a less functional version. The AmpliChip test works by detecting specific variations in genes that code for two important drug-metabolizing enzymes, CYP2D6 and CYP2C19. These enzymes help break down 25 percent of all drugs, including the most commonly prescribed drugs in the United States, such as antidepressants, blood pressure medicines, cough medicines, and painkillers.
People with genetic variations that give them less efficient versions of the enzymes, known as poor metabolizers, could have high levels of a drug in their body for a longer period, increasing the potential for side effects.

Singer goes on to describe her expensive, confusing odyssey into getting the test done (doctors didn’t know about it, techs had never performed it). You’ll have to read the article to find out her ultimate test results, but I can tell you that most doctors would not be surprised by the results…
More from Roche…
Flashback: AmpliChip approved by FDA…

Nicholas Genes

Nicholas Genes, MD, PhD, has been with Medgadget since almost the beginning. He's now Assistant Professor of Emergency Medicine at Mount Sinai, where in addition to patient care and teaching responsibilities, he studies EHR usability and physician uses of social media. Dr. Genes serves on the editorial boards of Emergency Physicians Monthly and Emergency Medicine Practice. More about Nick: http://nickgenes.com

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