Precision Medicine

The historic methodology employed by the health care system in the United States has been - one size fits all. Most research, dosages, tests and procedures have been based upon experimentation with white, adult males. As can be seen in identical twins, with identical genetic makeup, disease can be truly individualized. Personalized medicine, or precision medicine as recently termed by President Obama, takes information and knowledge gleamed from genomics, transcriptomics, epigenomics, proteomics, biomics, peptidomics, etc. and translates it back into the clinic; in the form of tests, therapeutics and procedures truly personalized to the makeup of the individual, treating the individual’s indication with precision.

Assurex Health, a private company provides an excellent example of precision medicine in action. Assurex Health has identified the genomic makeup profiles, needed for efficacy, for each of the leading psychoactive drugs commonly prescribed for depression. Their research has translated back into the clinic in the form Genesight, a proprietary genomics based mental health test. The test is meant to be utilized by psychiatrists to precisely pinpoint the medications deemed most efficacious, based on the patient’s mental health genotype. The Genesight test is currently the fastest growing medical diagnostic test in the world.

Another private company, Crescendo Bioscience, is using personalized or precision medicine to determine the disease activity of rheumatoid arthritis. Their research indicates rheumatoid arthritis disease activity (e.g. radiographic progression) can be directly correlated to the concentration of 12 protein biomarkers in patient serum. Crescendo Bioscience currently offers a proprietary test Vectra DA, which examines the concentration of the 12 biomarkers, and applies a weight based algorithm to obtain a disease activity score ranging from 1-100. Within the past several years both Assurex Health and Crescendo Bioscience were acquired by Myriad Genetics, Inc., a publicly traded corporation.

The power of personalized or precision medicine is immense. As we came to closure with the massive data collection event of the human genome project, a great many periphery fields have been spawned, allowing us to draw from information beyond genetics, into the individual themselves. Epigenetics, proteomics, transcriptomics, biomics, peptidomics, etc. allow researchers to obtain information that affects individuals with identical genetic makeups. Vectra DA and Genesight are two recent tests developed to probe the disease states of individuals, in this attempt to move beyond the one size fits all methodology historically governing health care in the United States.

GeneSight - Genetic Testing for Personalized Medicine Treatment [Internet]. [cited 2016Nov24]. Available from: https://genesight.com/

Hall-Flavin DK, Winner JG, Allen JD, Carhart JM, Proctor B, Snyder KA, et al. Utility of integrated pharmacogenomic testing to support the treatment of major depressive disorder in a psychiatric outpatient setting. Pharmacogenetics and Genomics. 2013;23(10):535–48.

Our patient experiences with Vectra DA [Internet]. Vectra DA Home Comments. [cited 2016Nov24]. Available from: https://vectrada.com/

Curtis JR, Annette H. Van Der Helm-Van Mil, Knevel R, Huizinga TW, Haney DJ, Shen Y, et al. Validation of a novel multibiomarker test to assess rheumatoid arthritis disease activity. Arthritis Care & Research. 2012;64(12):1794–803.