Essentially, pharmacogenomics is the study of genes that might affect how an individual responds to medicine – an area that has been growing and evolving over the past 10 years or so.
While pharmacogenomics is not yet a gazetted medical speciality, international and local bodies are already looking into its potential as a gamechanger in medicine.
At present, any medical professional may pursue their interest and further study in this area, and pharmacists in particular are well-placed to delve into pharmacogenomics, owing to their training in how medicines work and how people respond to them.
“Pharmacists can interpret genetic test results that guide the use of medicine, tailor medication regimes based on a patient’s genomic findings, advise doctors on the right medications and dosage for each patient, and help patients understand what their test results mean,” said Dr Mai Chun Wai, deputy director at the Institute for Research, Development and Innovation at IMU University.
“With conventional methods, therapy is guided by a framework; now, therapy can be guided based on what patients will respond to. With prior knowledge of their patients’ genetic makeup, doctors can prescribe medicine with more confidence, tailoring treatment plans that are more suitable for their patients.”
According to Mah, this reduces the likelihood of side effects, saves time and expense for the patient, and improves outcomes by ensuring they receive the medications that work best for them based on their genetic makeup.
As practical applications continue to grow, pharmacogenomics is already making waves internationally in areas such as cancer therapy, cardiology, psychiatry, infectious disease, and pain management.
In Malaysia, some community pharmacists and general practitioners already recommend genetic testing to their customers, which involves blood being drawn and sent to a laboratory that provides genetic sequencing.
These services are likely to become more widely available as interest continues to grow among private and public sectors.
“At this point, this is a very new field and there is a lot of groundwork to be done before we can apply its use locally,” Mai noted.
“For instance, we first need to build our body of scientific data that is relevant to our population, as most of the available data is based on western populations, with limited Asian data coming from China.”
He said other considerations include access and affordability, as genetic sequencing comes with a higher cost. “While the technology is becoming more available, it still costs more than a conventional blood test.
“In addition, medical institutions will need to have resources in place to integrate pharmacogenomics into clinical workflows and processes.
“On a national level, ethical and regulatory frameworks alongside clinical guidelines and protocols are essential to guide its use and applications, and protect patients’ privacy and genetic data to prevent misuse.”
Moving forward, Mah said, paving the way for pharmacogenomics will require its integration into medical and pharmacy curricula; practical training on interpreting genetic test results; and the development of tools to help integrate the field into the prescribing framework, together with continuing professional development.
Over time, with growing education and awareness among healthcare professionals as well as the public, we can look forward to improved application of pharmacogenomics in Malaysia’s medical landscape.