Personalized Medicine
More than six percent of acute hospital admissions are caused by serious adverse reactions to medicines Most common medicines are not effective in treating large numbers of the patients. Drugs used for specific treatments are not effective for every patient or group of patients as we expect (Roden D 2017; Walker L et all 2014; Langerova P. et all 2014; White K et all 2014; Kevin D et all 2014; Kant A et all 2013; Karen J 2012; Salvi F et all 2012; Ta Wu T et all 2010; Hacker M 2009; Maddison J et all 2008; Patel H et all 2007). Personalized medicine addresses these challenges, with tailor-made prevention and treatment strategies for individuals and groups. As a result, we have a win-win situation where patients receive the specific therapies that work best for them, and less money is spend on trial and error treatments. The control of healthcare costs is very important since costs across the world are rising, as the population ages. Also, chronic diseases become more prevalent and others spread more quickly as ever before, due to the increased mobility of the world population.
The concept of “personalized medicine” was anticipated in the late 1800s by Canadian physician Sir William Osler who noted “great variability among individuals”; however, the more modern definition has evolved to incorporate personal genomic information into a patient’s clinical assessment and family history to guide medical management (Alzu’bi A et al 2014; Esplin E et all 2014; http://www.personalizedmedicinecoalition.org). Current research in this field involve identifying the genetic basis of common diseases, studying how genes and the environment interact to cause human disease, and using biomarkers to facilitate more effective drug therapy (http://www.personalizedmedicinecoalition.org).
Although there is no universally accepted definition, the Horizon 2020 Advisory Group has defined personalised medicine as “a medical model using characterization of individuals’ phenotypes and genotypes (e.g. molecular profiling, medical imaging, lifestyle data) for tailoring the right therapeutic strategy for the right person at the right time, and/or to determine the predisposition to disease and/or to deliver timely and targeted prevention“. This definition was also used by EU Health Ministers in their Council conclusions on personalized medicine for patients, published in December 2015. Although some personalised medicine approaches have already been introduced into practice in Europe, they are still at an early stage of implementation. Significant paradigm shifts will need to take place in medical research and health care for this innovative area to be fully exploited.
Presently, the National Research Council (NRC) of United States, consider personalized medicine is an old term and preferred to use “precision medicine”. For the NRC, precision medicine is “an emerging approach for disease treatment and prevention that takes into account individual variability in genes, environment, and lifestyle for each person.”
There is a lot of overlap between the definition of the terms precision medicine and personalized medicine. However, there was concern that the term “personalized” could be misinterpreted to imply that treatments and preventions are being developed uniquely for each individual. In precision medicine, the focus is on identifying which approaches will be effective for which patients based on genetic, environmental, and lifestyle factors. While the NRC prefer the term “precision medicine”, others still use personalize medicine, or the two terms interchangeably.
In our group, we will be using Personalized Precision Medicine (PPM) o Medicina Personalizada de Precisión.
We see new challenges to contribute to Precision Personalized Medicine, and also a number of potential benefits:
Short and long term challenges that will become short and long term benefits:
- Wider ability of doctors to use patients’ genetic and other molecular information as part of routine medical care. (S Raghavan & J Vassy, 2014).
- Improved ability to predict which treatments will work best for specific patients.
- Improved approaches to preventing, diagnosing, and treating a wide range of diseases.
- Better understanding of the underlying mechanisms by which various diseases occur.
Challenges and the same time benefits from Information technology (IT)
- New approaches for protecting research participants, particularly patients’ privacy and the confidentiality of data (Sharyl J. et all 2009).
- Better integration of Electronic Health Records (EHRs) for patient care, which will allow doctors and researchers to access medical data more easily (Menachemi N & Collum T, 2011).
- Design of new tools for building, analyzing, and sharing large sets of medical data.
- Improvement of FDA oversight of tests, drugs, and other technologies to support innovation while ensuring that these products are safe and effective.
Long term benefits:
- New partnerships of scientists in a wide range of specialties, as well as people from the patient advocacy community, universities, pharmaceutical companies, and others.
- Opportunity for a million people to contribute to the advance of scientific research. Potential long-term benefits of research in PPM.