Medicine tailored to specific groups

"Personalised" medicine, targeted to specific racial, ethnic or other groups of people, can be beneficial in determining what will work for individual patients in various therapies, says Henry I. Miller, a fellow at the Hoover Institution and the Competitive Enterprise Institute.

There are a number of genetic diseases that occur predominantly in specific ethnic groups:
 

• A genetic test called the Ashkenazi Jewish Genetic Panel (AJGP) screens for a number of diseases that occur in Jews of Ashkenazi or Eastern European descent.
   
• Sickle-cell anaemia occurs exclusively in blacks; additionally, quinine-like drugs can produce a severe reaction in black men resulting in anaemia.
  Therefore, personalised medicine based on genetic tendencies and age would greatly benefit specific groups, says Miller:
   
• Patients of various races may respond to treatments differently; for example, BiDil, a new drug for treatment of severe heart failure, has been shown in clinical trials to particularly benefit black patients.
   
• Elderly patients are more likely to experience adverse drug reactions than younger patients, due to their reduced function of kidneys and liver.
   
• Additionally, older patients will respond differently to fat-soluble and water-soluble drugs due to their body composition; water-soluble drugs can become more concentrated in the blood, while fat-soluble drugs have longer half-lives.
  
  Though personalised drugs would benefit patients, many challenges remain. Drug companies may not have the incentive to research and develop drugs for which a narrow population is eligible. Also, some commentators view therapy designed for a specific group as discriminatory, says Miller.
  
  Source: Henry I. Miller, "Are We in a Brave New World of 'Personalized' Medicine?" Tech Central Station, August 17, 2005.
  
  For text:
  http://www.techcentralstation.com/081705D.html
  
  For more on Health Issues: Therapies and/or New Technologies:
  http://www.ncpa.org/iss/hea/
  
  FMF Policy Bulletin/ 6 September 2005