Race vs. personalized medicine. "Me-too" drugs that matter?
Since the advent of the Human Genome Project, scientists have salivated at the thought of truly personalized medicine: therapies customized at the molecular level to combat specific genetic deficiencies which can contribute to chronic illnesses like heart disease, high cholesterol, and many others. An unintended side-effect of this dream has been the introduction of "race" into the study of medicine. Naturally, this is a topic that is socially-charged, so the public is tempted to reject it out-of-hand. It feels warm and fuzzy to say that people are people, regardless of their genetic background.
Unfortunately, the data just doesn't support this assertion. It would be nice to treat everyone the same, but the data shows that some treatments work better in certain ethnicities than others. That's why you've got treatments like BiDil, the first drug therapy approved to treat high blood pressure in those of African-American descent. It just doesn't work well in caucasian people.
"I'm hoping there are a lot of drugs on companies' back shelves that, once you segregate their genetics, are going to have some value," said Stephen B. Liggett, a professor of medicine and physiology at the University of Maryland School of Medicine in Baltimore, who led the research.
I, personally, don't understand the irrational fear of medicine customized on the "racial" level. Doing this sort of crude study is, of course, the precursor to tailoring therapeutic regimens to specific individuals' genomes. Of course we're not anywhere near that level yet, but you can't start in the middle: you've got to start at the beginning, and the beginning is studying the differences between ethnicities. If something works better in one specific group of people than another, then it should be used. It should be studied in that group of people to further scientific understanding of the differences between that group and male caucasians, who have been the traditional demographic that most drugs are tested on before regulatory approval. (Though this is quickly changing, thankfully, as Big Pharma has realized that there are real therapeutic differences between what happens in white males and those who are not. Guess which group is bigger…)
Fortunately for everyone, scientists have learned to play the PC game too, and they're doing so by referring to these genetic differences as "continent of ancestry" to remove the charged "R" word from the discussion. Hey, whatever you've got to do to further our understanding is fine by me. AstraZeneca is doing it in China, and I desperately hope the PC crazies don't succeed in shutting down funding of initiatives that are studying "racial" aspects of medicine. Whether society wants to accept it or not, there are certain genetic predispositions and differences common to specific ethnic groups. Naturally it goes without saying that these differences don't make one group any "better" than another.
I've been a critic of Big Pharma's policy of evergreening older drugs in lieu of real, groundbreaking research, but it looks like it could be in their best interest to start testing some of their new (and old!) drugs in specific ethnic groups to see if there are different therapeutic outcomes. At the very least, it could lead to greater PR exposure and give their drug reps something new to work with when they're peddling their wares to prescribers. As pipelines run dry, this could become a bigger tool in their sales arsenal.
[tags]Medicine, pharmacy, me-too drugs, Big Pharma, race, personalized medicine[/tags]
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