NorthShore University HealthSystem serving the Chicago area is again partnering with Mayo Clinic in studying an individual’s genetic makeup to prescribe best medications.
This time, Mayo researchers are looking at patients’ genes known as CYP2C19 genotypes that metabolize drugs and synthesize cholesterol and steroids,
The patients have already undergone heart angioplasties.
In identifying genetics, doctors can give patients anti-platelet medication to reduce heart attacks, unstable anginas and strokes after stent placement by reducing blood clots around the surgical site.
“The current standard of care after angioplasty is to prescribe clopidogrel for one year, regardless of a person’s individual genotype, even though we have known for several years that variation in the CYP2C19 gene may diminish the benefit from the drug,” said Mayo Clinic cardiologist Dr. Naveen Pereira in a release.
“What we don’t know, and why there is such confusion in the cardiovascular community, is how these genetic changes affect long-term clinical outcomes and whether we can decrease overall health care costs.”
The research at Mayo is titled Tailored Antiplatelet Therapy to Lessen Outcomes after Percutaneous Coronary Intervention or the TAILOR-PCI study.
From NorthShore HealthSytem, head cardiologist Dr. Jorge Saucedo sends stent patient data to Mayo for analysis and eventual target drug prescription
“What we’re trying to do with TAILOR-PCI is to individualize the better anti-platelet therapy for patients with coronary stents based on their genotype,” said Sauceo of Winnetka.
“The future of medicine is that of giving each one of our patients the medications that work best for them based on their genotype and the TAILOR-PCI is one of the first studies in the cardiovascular arena to do so.”
Stent patients often take the blood-thinning drug Plavix; however, Saucedo said 30 percent of them did not have genes to metabolize it.
Some alternative medications, including Brilinta (ticagrelor), do not require activation through the same genetic pathway, according to Mayo Clinic.
“Ticagrelor has its own risks, including serious or life-threatening bleeding. Additionally, this alternative therapy costs approximately six to eight times as much and must be taken twice a day,” Pereira said.
So researchers and doctors continue studying what drugs are best.
“Not all patients react the same to medications ... in the way they metabolize drugs based on genes. Why treat them all the same?” Saucedo said.
In joining Mayo Clinic, NorthShore University is the only hospital system in Illinois participating in TAILOR-PCI.
NorthShore University HealthSystem has hospitals in Glenview, Highland Park, Evanston and Skokie.
Earlier this month, NorthShore announced another collaboration with Mayo in treating men with advanced prostrate cancer. Developed at Mayo in Rochester, Minn., the new therapy attempts to match new drugs with gene DNA of a patient’s tumor.
Doctors use exome sequencing, which is the coding portion of genes that are translated into important proteins, to identify molecular traits within prostate cancers.