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Using genetics to prevent adverse reactions to drugs

​​​​​​​​​​Spotlight on research

Murray Brilliant, Ph.D. Murray Brilliant, Ph.D.

​Adverse drug reactions (ADR) are a major health problem in the United States, accounting for more than 2.2 million serious cases and at least 100,000 deaths every year.

ADRs could be avoided if your doctor knew how you would react to a certain medication or combinations of medications. Now Marshfield Clinic Research Institute is joining with other medical institutions in the eMERGE Network in an effort to make that happen.

The Electronic Medical Records and Genomics (eMERGE) Network is a national consortium of nine sites organized to develop, disseminate, and apply approaches to research.

Murray Brilliant, Ph.D., director of the Center for Human Genetics in Marshfield, said a pilot study being developed in Marshfield for eMERGE will collect blood samples from healthy individuals who are Marshfield Clinic patients. The DNA in the blood will be analyzed to determine whether it contains any of the 84 genetic variations that are known to make people susceptible to an ADR from certain drugs.

The co-principal investigators of the Marshfield study are Dr. Brilliant and Medical Geneticist Arial Brautbar, M.D. Dr. Brautbar is also a lipidologist, who studies fats in the blood such as cholesterol that are known to cause narrowing in blood vessels.

"We're recruiting up to 750 Marshfield Clinic patients over the age of 50, who have never been given the anti-clotting drugs warfarin (Coumadin) or clopidogrel bisulfate (Plavix), or the blood-thinning drug simvastatin (Zocor)," Dr. Brilliant said. These commonly prescribed drugs are known to produce ADRs in some patients, but there has been no simple way for doctors to know which patients are susceptible.

If any of these known variants are discovered in the patient's blood, it will be noted in the patient's electronic medical record. That's highly significant by itself.

"This is the first time here at Marshfield Clinic that this type of information will be put in the electronic record as a tool for physicians," Dr. Brautbar noted. "If one of these study participants with one of the variants is prescribed one of these three medications, that information will pop up in the medical record. It will provide guidance to the physician and pharmacist to determine the appropriate dose for that patient, or whether another medication should be prescribed instead. The record will also show if the patient is responding well to the medication.

Drs. Brilliant and Brautbar hope this will lead to many more drugs being studied in this way, and that research in the future will be able to determine that this system did in fact prevent ADRs in these study participants.

If you fit the description above and would like to volunteer for this study, contact Research Coordinator Wendy Foth at 715-389-4470, or by email at foth.wendy@marshfieldclinic.org.​