Precision medicine is on the way to mainstream healthcare

Precision medicine is a medical model that proposes the customisation of healthcare with medical decisions, treatments, practices or products being tailored to the individual patient. In this model, diagnostic testing is often employed for selecting appropriate and optimal therapies based on the context of a patient's genetic content or other molecular or cellular analysis.

Sometimes the term personalised medicine is used interchangeably with precision medicine but there is vast difference between two, do not be misinterpreted that personalised medicine refers to manufacture a unique medicine to one by one patients.

Advances of molecular medicine have been emerged in the newer field of pharmaco-genomics which enables to interpret of drug response. Personalised medicine is considered an extension of traditional approaches to understand of treating disease with a greater precision, that is why it is called precision medicine too. "One size fits all" traditional model gets new window where a patient's gene variation can guide treatment protocols that minimises harmful side effects or ensure more successful outcome. The benefits of pharmaco-genomics are important in all aspects to the physicians and patients:

• Shifting emphasis in medicine from reaction to prevention
• Enabling the selection of optimal therapy and reducing trial- and- error prescribing
• Making the use of drugs safer by avoiding adverse drug reactions
• Increasing patient's compliance with treatment
• Reducing the time and cost of clinical trial
• Reducing the overall cost of health care.

Pharmacogenomics is the study of genes that affects a person's response to the drugs. Many drugs that are currently available are "one size fits all," but they don't work the same way for everyone. It can be difficult to predict who will benefit from a medication, who will not respond at all, and who will experience negative side effects (called adverse drug reactions). Most of the drugs undergoes through first phase metabolism by Cytochrome P450 (CYP 450) enzymatic system.

Variation of single nucleotide of that particular gene of metabolising enzyme can cause drug efficacy and toxicity in a greater extent. The desired efficacy may not be acquired even of having the mutation in drug transporters and its receptor gene as well.  In the molecular biology it is called SNPs (Single Nucleotide Polymorphism). Simply, genes are a segment of DNA that are found in all human cells, the particular genes are having a specific job to keep our body function continue. The drug metabolising enzymes are there too in the liver mostly. A single mutation of that particular gene can influence greatly a person's response to medications.

If there is a test to predict adverse reactions or resistance to a drug or to target patient selection for a clinical trial, the risk of clinical failure drops significantly. In this modern age integration of information technology with molecular biology aided a lot in the field of personalised medicine by exploring the knowledge of the human genome.

In the future, pharmaco-genomics could have an expanding role in the practice of medicine.

The writer is the CEO of NIPRO JMI Pharma Ltd. Email: mizan_ceo@niprojmipharma.com