Clopidogrel is a commonly prescribed medicine used to prevent blood clots, but doctors and researchers have known for many years that it doesn't work for everyone. For clopidogrel to work, the drug must first get metabolized into its active form. However, not all people can do this based on their genes, leaving them at higher risk for a heart attack or stroke.
Scientists at Marshfield Clinic Research Institute are working to reduce the risk for bad outcomes related to many drugs influenced by genes. Currently, 1,400 patients at Marshfield Clinic Health System have completed genetic testing with an additional 1,600 patients soon to receive their results. This genetic information is being placed into the Health System's prescription software. When a doctor tries to prescribe a medicine that doesn't work for one of their patients, like clopidogrel, the computer sends an alert to the doctor and provides advice for alternative medicines.
“Only the large academic health systems are doing this and we are further along than many of them," said Scott Hebbring, Ph.D., research scientist at the Center for Precision Medicine Research at the Research Institute and primary investigator for the study.
This type of research is called pharmacogenomics, a new area of medicine that considers a patient's genetic variants before a physician prescribes or a pharmacist dispenses a medicine.
“This program is using decades of research on genetics to help patients get the right drug at the right time at the right dose," Hebbring said. “We are trying to implement customized clinical care using genetics."
While this clinical grade genetic data is currently being collected through research for a few thousand patients, Hebbring and the other staff members involved are looking towards the future when the Health System collects and interprets this information for all patients.
“Having the ability and opportunity to know more about each patient's individual response to different medications is a game changer for clinicians," said Karen Shulman, M.D., family medicine physician at Marshfield Clinic Stratford Center, who has some patients enrolled in the study. “I am optimistic about the broad benefits all will enjoy as this important research progresses and expands into mainstream clinical medicine."
Hebbring would like to thank the generous donors and research participants for supporting this study. He would also like to thank the staff of the Center for Precision Medicine Research, Office of Research Computing and Analytics and others across the Health System for their hard work.
For more information on participating in a similar precision medicine program, please contact Marshfield Clinic Health System's All of Us Research Program at 888-633-9987 or visit JoinAllofUs.org/marshfieldclinic.