UCSF pharmacy school one of nation’s first to offer students genetic testing for drug response.
When Julia Choi’s grandmother suffered her third stroke, a doctor in the emergency room gave her blood thinner medication to prevent another stroke. Not long after, Choi’s grandmother experienced gastrointestinal bleeding – a common side effect of blood thinners. She later passed away. Choi never found out if the bleeding was indeed caused by the drug or by something else.
The memories of her grandmother’s struggle came flooding back to Choi last spring when she took a course in genetics and drug response as a first-year pharmacy student at UC San Francisco. Not only did she learn that some people carry variants in their genes that cause adverse reactions to clopidogrel, the drug her grandmother had been given, but Choi also had the opportunity to have her own genes tested for such mutations.
The UCSF School of Pharmacy is one of the first pharmacy schools in the nation to offer its students genetic testing for drug response. It’s just one way UCSF is educating students about precision medicine – an emerging approach that collects and integrates vast amounts of data and new technologies to develop individualized treatments. As the health care providers of the future, today’s students will be diagnosing and treating patients based on a barrage of information not just about the person in front of them, but also about millions of other patients around the world.
Genetic codes; environmental and nutritional data; reports from patients’ electronic health care monitors; and input from epidemiologists, informaticians and scientists studying the molecular underpinnings of disease – all these factors must be considered in the world of precision medicine. The upside is that “we will be able to find the right treatment for our patients, without going through all the trial and error we do today,” says Catherine Lucey, M.D., a resident alumna and the vice dean for education at UCSF School of Medicine.
“What’s so great about being at UCSF is that we’re fortunate enough to have people who strive to practice tomorrow’s medicine today,” she continues. The university has been educating its students regarding precision medicine for years by teaching them about genetics, population-based clinical research, and the nature and importance of working in multidisciplinary teams.
As Choi learned firsthand in the School of Pharmacy’s Genetics and Pharmacogenetics course, a single gene can influence drug response – knowledge that is shaping more precise approaches to therapeutics.
She was one of 22 out of 122 students in her class to opt in for the genetic testing, which evaluated the CYP2C19 enzyme. People who have variants of this enzyme can over- or under-metabolize clopidogrel (also known by the brand name Plavix), which means they are 3.6 times more likely to suffer a heart attack, stroke, or even death. These outcomes can be easily avoided, however, by first testing a patient for the genetic mutations and then prescribing a higher or lower dose of the drug or another drug entirely.