Nearly one-in-10 side effects from medicines are potentially preventable by doctors giving people a genetic test beforehand, a study has found.
The test, which could be done on a finger-prick blood sample or cheek swab for approximately £100, would only have to be done once, with the results kept in personal GP records, so they could be checked whenever a new medicine is prescribed.
“It’s a once-in-a-lifetime task, where it could inform prescribing throughout life,” said Dr Emma Magavern, an internal medicine doctor at Queen Mary University of London.
People can buy such tests from firms offering online genetic testing kits but they are not available through the NHS at the moment, apart from for a few less commonly used drugs.
Side effects from medicines range from mild symptoms, like nausea or a rash, to potentially deadly ones, like blood clots or heart rhythm changes. They are responsible for one-in-six emergency hospital admissions, and the cost to the NHS is estimated to be more than £2bn a year.
People vary in their susceptibility to side effects, partly due to factors such as their age or underlying health complications. Over the past two decades, several genetic variants within our DNA that also influence our response have emerged.
In the new study, published in the journal, PLOS Medicine, Dr Magavern’s team analysed all entries to the UK drug regulator, the Medicines and Healthcare products Regulatory Agency (MHRA), through its “Yellow Card” side effect reporting scheme, since its start, 60 years ago.
There were 1.3 million such reports, covering nearly 2,500 different drugs; 5 per cent involved deaths, while another 65 per cent were classed as serious.
The researchers found that 9 per cent of all the Yellow Card reports involved drugs causing a side effect where the risk could be reduced if doctors know someone has high genetic susceptibility. A doctor could, for instance, lower the dose of the medicine or choose a different one to prescribe.
Three genetic variants were involved in most of the reported side effects. Two affect the way the liver metabolises drugs, while a third affects the rate at which the liver takes up medicines. “Variants in those genes impact on the prescribing of so many different medications,” said Dr Magavern.
In future, people could have a cheek swab taken or give a blood sample to reveal which genetic variants they have. This could be done at birth or when people first need to take a prescription medicine, said Dr Magavern.
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Read MoreIf the NHS introduces such testing, it would make sense to roll it out first for people starting new medicines for mental health or heart conditions, as these areas were where most drug side effects were reported, said Dr Magavern. “If we must target areas, we target psychiatry and we target cardiovascular, as we know it’s high-impact,” she added.
June Raine, chief executive of the MHRA, said: “This study shows how reports of suspected side effects to the Yellow Card scheme can help us better understand and prevent serious side effects, including those linked to genetic factors.”
Professor Peter Donnelly, head of Genomics, a firm that offers tests for disease risk, said genetic tests could also predict if people are likely to benefit from certain medicines, as well as have side effects. “That gets the right drug for the right person,” he said.
A spokesperson for NHS England said: “The NHS Genomic Medicine Service is actively using genomic testing to predict and prevent adverse drug reactions in patients – including identifying genetic variants associated with specific drug responses – and we are continuing to expand and embed this into routine care.”
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