Researchers study how genes affect people’s response to drugs

An ongoing largest pharmacogenomics project funded by Qatar National Research Fund aims for a deeper understanding of rare and common pharmacogenomics variance in the country.Pharmacogenomics (Pgx) is the study of how differences in genes affect people’s response to drugs, a relatively new field. Dr Amal Robay, assistant professor at Qatar Foundation (QF) partner, Weill Cornell Medicine-Qatar, and the lead researcher of the project, says pharmacogenomics is a critical part of precision health.“We all have small differences or variants in our genetic code. In some cases, these variants can be the reason we respond differently to medication, making it difficult to predict who will benefit from a medication and at what dose, and who will experience negative side effects,” said Dr Robay.According to an article on QF's website, the project has a sample size of more than 18,000 genomes, with 15,000 from QF’s Qatar Biobank and 3,000 from WCM-Q’s biobank, and 300 Intensive Care Unit patients recruited from Hamad Medical Corporation (HMC).The project aims to analyse a larger number of Qatari genomes to predict and validate novel variants that alter drug metabolism in the Qatari population. After a genome is sequenced, computational software is used to find novel variants in the genes. The identified variants are then checked to see if they are involved in the metabolism of a drug, and if so, the software suggests how this variation affects drug metabolism.“We need Pgx to deliver precision health in Qatar. As of now, we don’t have enough knowledge about the prevalence of Pgx variants in Qatar, and that is why this project is important. It is the first step in filling in the gaps about Pgx variants in Qatar and eventually contribute significantly to improved and individualised healthcare,” explained Dr Robay.The team is also looking at 91 commonly prescribed drugs at HMC’s ICU, and through this study, attempting to identify genetic variants in the Qatari population that are known to affect the metabolism of these drugs.Dr Ali Ait Hssain, senior consultant, ICU, Hamad General Hospital, also a member of the project, said: “Time is critical in the ICU. Every minute matters, and the delay caused by trial-and-error when it comes to medication can have drastic consequences.”He added that the average time a patient spends in the ICU is 10 days, and patients are often on as many as 20 medications at the same time, so there is a significant amount of drug interaction and this can increase chances of complications from adverse drug reactions.Dr Robay noted: “The way our bodies metabolise – break down – and remove medicines differs from one person to another. In some people, a medicine might break down too quickly leading to side effects due to the high level of medicine in the body, whereas in others it might break down too slowly which means the medicine takes too long to be at a level where it is effective.”Screening of Pgx variants enables precise dosing for individuals that are fast or slow metabolisers of a prescribed drug, as well as identification of individuals at risk for adverse reactions. The goal of Pgx is to use it as a clinical tool to guide drug selection and dosage optimisation, to allow doctors to make informed decisions.“Availability of Pgx data for each patient upon admission could potentially help avoid overdose, underdose or adverse drug interaction situations. This will allow doctors to provide Qatari patients with safer and effective therapies and avoid wasting time and money on treatments,” Dr Hssain added.