tag:blogger.com,1999:blog-6173393362223742012.post180543032298001320..comments2023-08-24T08:30:25.608-07:00Comments on Gene Sherpas: Personalized Medicine and You: Personalized Medicine since 1986???Steve Murphy MDhttp://www.blogger.com/profile/11774190000307343476noreply@blogger.comBlogger2125tag:blogger.com,1999:blog-6173393362223742012.post-33122834683269099532007-06-21T12:54:00.000-07:002007-06-21T12:54:00.000-07:00Dear Steve - Thank you for your post. I read your...Dear Steve - <br>Thank you for your post. I read your recent post with interest. I have been involved with personalized medicine for several years and my colleagues have been involved in actually "reducing to practice" the concept. At our former company, we brought to market and built to blockbuster status TPMT Genotyping and Enzymology testing for the purposes of identifying those at risk for myelosuppression on thiopurines, as well as to guide initial dosing. We then also built to blockbuster status thiopurine therapeutic drug metabolite monitoring to measure efficacy and compliance. We brought these products to market in gastroenterology where thiopurines are used to lessen IBD patients' use of steroids, specifically in severe Crohns' patients. Whereas the "standard of care" was to start with a low dose and titrate up until a side effect was present (pancreatitis, myelsuppression, etc.), we offered a personalized medicine alternative of being able to predict the moderate and high risk patients to make more educated dosing decisions, and then truly understand how a patient was metabolizing the drug upon commencing therapy. Though these therapeutics are used off-label by gastroenterologists, we built a valuable relationship with them. We had 79% of GI's in the U.S. using the technology and 30% of all new Rx's on thiopurines receiving the test up front and ongoing (annual basis) TDM. We were able to not only get most GI physicians to use the technology, but since many IBD patients are diagnosed between 15 and 29 years of age, it was a welcome advance for the parents of these children and young adults who want only the best for their children. This was such an accomplishment that despite not having prospective data, only restrospective analyses, we were able to get the FDA to approve amendments to the package inserts of all thiopurine drugs to mention the availability of such testing - without the tests being FDA approved. <br><br>So yes, personalized medicine has been around and we had been doing it since the late 1990's. Our team has experience getting physicians to order it, patients to ask for it, parents of patients to demand it, insurance companies to pay for it, and the FDA to include it in package inserts without formal FDA pre-market review. <br><br>Today, some of the persons responsible for this huge accomplishment have joined forces to bring many of these technologies to market to address personalized medicine - both from a conventional medicine (pharmaceutical) and complementary and alternative medicine (nutraceutical) standpoint. That company is Salugen, Inc. Check us out sometime, I'd love to discuss it with you. <br><br>Best of luck with your clinic in The City.Brian Meshkinnoreply@blogger.comtag:blogger.com,1999:blog-6173393362223742012.post-30409118175696479342007-06-21T18:13:00.000-07:002007-06-21T18:13:00.000-07:00Brian,I appreciate your work. I personally had a p...Brian,<br>I appreciate your work. I personally had a patient in my emergency room who missed his "blood draws" while on 6MP. He had no white blood cells and was septic. The cost of his stay 120k, the costs of TPMT testing prior would have been priceless. He has absent enzyme activity. Send me an email. I would love to chat.<br>-SteveSteve Murphy MDhttp://www.blogger.com/profile/11774190000307343476noreply@blogger.com