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The University of Liverpool Podcast Professor Sir Munir Pirmohamed is the Head of Molecular and Clinical Pharmacology at the University of Liverpool, and the NHS Chair of Pharmacogenetics in the UK. His research focuses on individual variability in drug response, and he has written more than 350 peer-reviewed publications. Sir Munir appeared on the University of Liverpool Podcast to discuss the history and theory of personalised medicine, as well as the advances being made in this exciting field.

5 reasons personalised medicine is transforming healthcare

  1. The concept of personalised medicine has already been proven
    Assessing a patient’s suitability for specific medicines is becoming increasingly common – and with good reason, as not all medications are suitable for all patients.

    For example, abacavir, a drug used in the treatment of HIV, causes a severe reaction (and sometimes death) in up to 7% of patients – prompting three teams of researchers, in Australia, North America, and Liverpool, to work together to find a genetic marker for the reaction.

    Their efforts were successful, and since 2006 a test has been introduced across most of the Western world. “The net effect has been dramatic,” says Sir Munir. “Since testing has been introduced, abacavir hypersensitivity has virtually disappeared.”
  2. There are significant economic benefits
    The costs involved in researching and developing tests, and then administering those tests to all patients, are far from insignificant. However, treating patients with Abacavir hypersensitivity can cost up to £20,000.

    In fact, the cost of treatment was so high that Munir’s team found it was cheaper to proactively test all patients and provide personalised medicine accordingly, rather than reactively treat those patients who exhibited hypersensitivity.
  3. It leads to more accurate drug doses
    Sir Munir says: “If I gave 100 people the same drug at the same dose, there would be a marked variation in how much of that drug actually gets into the bloodstream.”

    Warfarin, a blood thinner also found in rat poison, is used to prevent blood clots in roughly 1% of the population of the UK and United States. Doses range from half a milligram a day to 20 milligrams a day. Among the white Caucasian population, a patient’s age and body mass index (BMI) both affect the dose a patient needs. Two genetic factors also have an effect.

    “When we put it all together, we find that the genetic factors account for more of the individual dose variation,” says Sir Munir. “You can [now] account for about 60% of the dose variation in warfarin per day… [which is] much better than the 5% we had before.”
  4. Patient data is increasing
    Around the world, some patients’ genetic information is already being stored as part of their medical records.

    Sir Munir points to a case in Florida where individuals have been genotyped. When the patient comes to the doctor, it is flagged that the patient has a particular genetic variation. The doctor can then take this information into account when prescribing medication, by trying an alternative drug, for example, or changing the dose for that individual.

    Sir Munir expects this approach to be further developed in the coming years. “It’s likely that there will be more and more of the population [that] will have their whole human genome sequenced.”
  5. The pace of progress is rapid
    Sir Munir believes medicine could be transformed by the changes expected in the years and decades ahead, as technology advances and the availability of patient data continues to increase.

    “It’s advancing very quickly,” he says. “The sequencing technologies are becoming more and more efficient, the cost of sequencing is also going down, and the ability to analyse a genome is improving rapidly.”

    It is a transformation that could lead to personalised, more effective treatment for a larger number of patients – and that has got to be a good thing for all us.

About this podcast

The University of Liverpool Podcast aims to bring listeners closer to some of the academic experts, authors and innovative thinkers from the University who, through their in-depth analyses, research and discoveries, are affecting positive change in the world today. Each episode features one or more of our academic experts discussing research in their specialist field. Subscribe to the University of Liverpool Podcast via iTunes, Tunein and Google Play Music (US and Canada only).

Interested in learning more about the University of Liverpool’s online health programmes? Find out more about our APHEA-accredited online Master of Public Health (MPH), online MPH – International Public Health, online MPH – Management of Health Systems.

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