SEATTLE, April 3, 2008 /PRNewswire/ -- A policy comment in Science today quotes Genelex out of context:
"Some Web sites make explicit claims about the utility of CYP450 testing for particular drugs, such as the claim by Genelex that pharmacogenetic testing is "required to effectively prescribe Paxil" (http://www.healthanddna.com/professional/paxil.html).
The actual statement is:
Paxil (paroxetine) is metabolized through CYP2D6. Pharmacogenetic
testing of this pathway serves as an anchor for the intense personalization
required to effectively prescribe Paxil and other antidepressant medicines.
Facts and quotes:
-- "The cytochrome P-450 test represents a major advance in the ability
to provide the best care possible for depression."
-- Hospitalized psychiatric patients who are poor metabolizers cost
$4,000 - $6,000 more in medical care compared to patients with an
average metabolizer genotype. Virtually, all antidepressants and
antipsychotic medicines are processed by enzymes with a high
incidence of poor metabolizers. Journal of Clinical
Psycopharmacology 20:246 2000.
-- Fifty-nine percent of drugs most commonly cited in ADR studies are
processed by enzymes with genes known to have poor metabolizer
variants. This is compared to 7% of a random selection of the top
selling drugs. (JAMA 286:2270 2001).
-- Multiple studies have found that people with CYP variants require
lower doses of the affected medications. Molecular Psychiatry
-- "Putting what we know into practice would prevent more disease than
worshiping at the altar of randomized trials." John Concato, MD,
-- Individuals have a right to learn their genotype and control who
accesses this confidential information.
-- Excessive regulation will impede the already slow adoption of DNA
testing in medication management.
-- There needs to be symmetry between the level of proof required for
technology adoption and the potential risk and cost benefit ratios.
-- A peer-developed rating system needs to be developed that describes
where a given test lies on the continuum of scientific knowledge
about the utility, acceptance and proof of that test as a tool for
Randomized trials are in progress that will add to our knowledge. In the meantime clinicians and patients who find this information useful should have access to it. Physicians don't prescribe without knowing the patient's age, sex, and medical history, and often CYP genetics are more important than all these factors combined.
|SOURCE Genelex Corporation|
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