What is Pharmacogenomics (PGX)?
PGx is the study of genetic variations that influence medication response. PGx is now enabling doctors to test for specific genetic changes to predict whether a patient may have a normal response, a poor response, or a higher risk of side effects before prescribing a specific medication.
Did you know?
1 in 5
Australians suffer from persistent pain, making their risk of depression 4x higher than those without pain1.
50% Of Patients
respond to the initial treatment with antidepressants2.
1 in 10 People
may process certain medications too slowly, increasing their risk of side effects3.
1 in 3 people
may process certain medications too quickly, increasing their risk of treatment failure3.
About our test
The myDNA Medication tests use pharmacogenomics to identify variations in a number of genes that influence medication response.
Currently, myDNA Medication reports concentrate on the genes encoding the metabolising enzymes (i.e. CYP450 enzymes) which are found mainly in the liver as well as the gut wall. These genetic variations predict the level of enzyme activity which in turn results in increased or decreased plasma concentrations and drug exposure.
Increased plasma concentrations, due to reduced enzyme activity, can lead to adverse effects. Reduced plasma concentrations, due to increased enzyme activity, can lead to poor therapeutic response.
myDNA offers a multiple gene medication test, which covers multiple medication categories (currently in excess of 80 medications). If information on medications in a specific therapeutic area is of interest, myDNA offers four single category medication reports as shown below.
- Pain medication
- Mental health medications
- Cardiovascular medications
- Gastrointestinal medications.
The customised reports written by the myDNA Clinical Team provide medication-specific prescribing considerations to help improve the safety and efficacy of medications and reduce the risk of unwanted side effects
Enzyme function can also be affected by factors other than genotype, including age, the effect of co-administered drugs (i.e. drug-drug interactions), and the presence of liver disease. These should be taken into account when considering the myDNA Medication Reports.
Reports must be delivered by a suitable healthcare professional. myDNA provides training for medical staff to assist in the understanding of these reports. If you would like to know more about this training, please email us: firstname.lastname@example.org.
After the results consult you can provide patients with ongoing access to their report via their own secure online portal, through provision of their unique access ID as noted at the end of the report.
hear from two of our customers
What are the clinical benefits?
Reduce the risk of adverse drug reactions
Reduce wasted cost and time on ‘trial & error’ medicines
Lifetime relevance—results can be referred to for subsequent treatment
Help to reach treatment goals sooner
THE PATIENTS LIKELY TO BENEFIT FROM MYDNA TESTING INCLUDE THOSE WHO ARE:
All patients may benefit from PGx testing, however some patients are more likely to see an immediate benefit from PGx testing, including those:
- Experiencing side effects to specific medications;
- Not responding to specific medications;
- Requiring doses of specific medications outside the recommended range; and
- Taking multiple medications.
Medication covered by the myDNA medication test
The myDNA Medication test examines the important DNA variants that affect drug response for over 80 medications used in clinical practice. These include certain antidepressants, antipsychotics, analgesics, anticoagulants, antiplatelets and proton pump inhibitors. Current TGA regulations prohibit the myDNA website from listing individual medications by name, but a list of the main medications that can be tested for is available for doctors and pharmacists. Please email us: email@example.com to request a copy of the myDNA Quick Reference Medication list.
EVIDENCE BEHIND PHARMACOGENOMIC TESTING
In our reports, myDNA references the guidelines of the Royal Dutch Pharmacists Association – Pharmacogenetics Pharmacogenomics Working Group and the Clinical Pharmacogenetics Implementation Consortium (CPIC). Generally, the emphasis is on CPIC guidelines, given their more recent publication.
The following published guidelines contain evidence for gene-drug associations for which dosage adjustments have been recommended. These can be accessed online at CPIC.
- CPIC Guideline for CYP2D6 and CYP2C19 genotypes and dosing of Tricyclic Antidepressants
- CPIC Guideline for CYP2D6 and CYP2C19 genotypes and dosing of Selective Serotonin Reuptake Inhibitors (SSRIs)
- Dutch Pharmacogenetics Working Group guidelines which include a number of antidepressant and antipsychotic medications
How to order
Discuss PGx medication testing with your patient.
Request a PGx medication test with a standard request form.
Remember to list patients’ medications.
Patient should pay at www.gdpay.com.au before visiting any Dorevitch, QML, Western Diagnostic, Laverty, TML or Abbott Pathology Collection Centre and record their receipt number on their form.
This test has NO medicare rebate. Call 1800 822 999 for any enquiries.
Patient visits any Dorevitch, QML, Western Diagnostic, Laverty, TML or Abbott Pathology Collection Centre with request form for blood collection.
The patient report will be delivered by your preferred method. A pdf report with further recommendations and insights is available on a secure doctor portal by using the link at the end of the report.
You can provide your patient with access to the pdf version of their report using their unique patient access code and the link at the end of the test report.
Alternatively, the patient can be referred to a pharmacy participating in the myDNA program for a cheek swab, at a cost of $149 for the myDNA multiple category test and $99 for any of the four single category tests. It is also possible for a patient to purchase a cheek swab kit through the myDNA website and have the results sent directly to their treating doctor. The cheek swab and blood sample results are the same. Results are typically available 10-15 business days after the laboratory has received the sample. Reports are sent via fax or through a secure myDNA online partners portal.
1. Painaustralia (accessed 2019)https://www.painaustralia.org.au/static/uploads/files/mr-mental-health-week-102017-final-wfdqwaehtcgj.pdf
2. Rush AJ, Trivedi MH, Wisniewski SR, Nierenberg AA, Stewart JW, Warden D, et al. Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps: a STAR*D report. Am J Psychiatry. 2006;163(11):1905-17.
3. Hicks JK, Sangkuhl K, Swen JJ, Ellingrod VL, Muller DJ, Shimoda K, et al. Clinical pharmacogenetics implementation consortium guideline (CPIC) for CYP2D6 and CYP2C19 genotypes and dosing of tricyclic antidepressants: 2016 update. Clin Pharmacol Ther. 2017;102(1):37-44.