Pharmacogenetics: The Solution for All Future Challenges?

Around 15 years ago pharmacogenetics was predicted to revolutionize pharmacotherapy. Patients would no longer be treated with standard drugs in a standard dosage. Instead, the right drug in the right dose would be selected for each individual based on a genetic test. Individuals likely to experience adverse events would be identified prior to drug treatment, and personalized medicine would be within close reach. Unfortunately, this prediction has not materialized. Although pharmacogenetic studies have found correlations between pharmacokinetic parameters and gene polymorphisms for a large number of drugs, very few physicians have ordered pharmacogenetic tests for their patients outside clinical trials. Technical advances have outpaced clinical implementation. The time needed to genotype, and the cost associated with these tests, have been reduced to a level that is no longer prohibitive for widespread use. Not only detection of single-nucleotide polymorphisms (SNPs), but also more extensive whole-genome sequencing is now widely available.

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