Friday, October 8, 2010
Way back in 2008 I mentioned an article, which I hoped would pan out. Or at least I hoped it would point the way to a model of PGx research which would be followed by pharma and alike to find associations to help us target the right medication for the right patient.
While the similar model followed through with Plavix, the initial study did not.
Which is why when the Berkeley Heart Lab guy came last week, I told him I would not be testing for Kif6. It had not been replicated in further GWAS.
A VAP cholesterol panel, a HsCRP, a family history and a blood pressure can help me predict risk much better.
The problem and backlash facing DTCG and DTMD genetic test purveyors is
the 'Ol "Your million dollar major study now rushed to market has just been refuted"
Yes this happens in biomedical science and in medicine ALL THE TIME.
Bed rest for MI anyone?
Low Dose Dopamine?
I could go on and on, but I won't
Put simply, the majority of the genome is NOT ready for clinical medicine or clinical decision making.
It won't be for 20 years.
That doesn't mean there aren't some things we can use.
2. MMR genes
4. CYP2D6, sometimes.....
5. SCD genes
6. Counsyl universal carrier screening
If a gene test comes to market that purports disease risk it had better be studied for at least 5 years before it comes to market.
Post market surveillance did not protect all those patients on Statins, "just because" of Kif6 risk.
Get it? These tests can lead to incorrect medical decisions....
Which can lead to risk.
Yes, even the DTCG tests can fool doctors and patients.
The Sherpa Says: If 2008 was the year of the GWAS, will 2011 be the year of the overturned GWAS?