Who Should Consider Pharmacogenetic Testing?

When Might Pharmacogenetic Testing Be Right for You?

Pharmacogenetic testing can be relevant to a number of individual circumstances and needs. As scientists continue to study associations between medications and genetic variations, the ways in which pharmacogenetics can help is expected to grow. However, in the present, we do know that it may be particularly beneficial in certain circumstances and specific cases, respectively. This may help answer the question "who should consider pharmacogenetic testing?".

Circumstances

Preventative testing can be done without any visible need in mind. The goal is to be prepared if and when health circumstances change, particularly since results would be immediately at the disposal of the individual and their health care provider in the case of an urgent situation. This is further supported by the idea that a person's genetics stay the same over a lifespan*. The earlier testing is done, the greatest potential exists to positively impact medication response for medications with established pharmacogenetic associations (and that are included on the test).

Pre-treatment testing can be done when a need for treatment has been identified, but the urgency to start is low (at the discretion of the health care provider). In these cases, pharmacogenetic testing can be done when one or more of the medication options under consideration have established pharmacogenetic associations and are being tested. When pre-treatment testing is done, results may also be referenced in the future so there is a preventative aspect included as well. 

Reactive testing occurs when an individual has previously had a poor response (i.e., "medication not working for me" or "medication causing side effects for me") with established pharmacogenetic association(s) included on the test. Though pharmacogenetic recommendations are often given from a forward-looking perspective (i.e., a medication is being considered for use for the first time), test results can often provide colour because a predicted response may help validate a previous experience when added to non-genetic factors, under the judgement of a health care provider. This greater certainty can be a source of relief and may even help determine if the medication should be continued, its use modified or discontinued altogether. When reactive testing is done, results may also be referenced if the health care provider is considering an alternate treatment, or, in the future as needed. As a result, there are preventative and pre-treatment aspects to reactive testing as well.

Specific Cases

Though not a definitive list, thaere are specific cases in various circumstances that can help determine "is medication genetic testing right for me?".

Individuals may be fearful of having a poor response to a prescribed medication under consideration. This could be based on prior experience, experiences of family or friends, or any other reason. In these cases, pharmacogenetic testing for the medication in question can provide more information about the risk of certain abnormal responses and may also provide details on alternatives (depending on what is being treated). 

In cases where finding a beneficial treatment as soon as possible is especially important, pharmacogenetic testing for the treatment options tested can help minimize the need for trial-and-error (including trying different medications that are not working).

Many other cases can be related to the specific medication being tested. This is because some medications can be highly toxic (e.g., capecitabine, azathioprine) or may not provide any obvious clues about being ineffective until a major health event occurs (e.g., clopidogrel). 

It should be noted that pharmacogenetic testing is limited to the medications and specific associations with the genetic variations included. This may mean that a specific aspect of response may not be related to the presence or absence of genetic variations. Clinical factors (e.g., organ function, drug interactions) can impact the predictability of response from pharmacogenetic testing and requires assessment by a health care provider. Risk of allergic reactions are not considered in pharmacogenetic testing. Additional information about limitations is available here.

*= Medication recommendations associated with genetic variations may change or become refined over time as ongoing study occurs. The Inagene Advantage Membership can be purchased as an add-on to provide automatically updated results.

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