A new analysis of six decades of adverse drug reaction (ADR) reports in the UK has revealed that up to 1 in 11 medication side effects could potentially be avoided by tailoring prescriptions to a patient’s genetic makeup. The findings, published in PLOS Medicine, highlight the value of pharmacogenomic testing and point to psychiatry as a key area for implementation.
Researchers from Queen Mary University of London examined more than 1.3 million ADRs reported through the UK's Yellow Card scheme, identifying over 115,000 (9 percent) linked to drugs known to interact with specific genetic variants. These are medications for which guidelines already exist recommending altered prescribing based on a patient’s genetic profile.
Notably, just three genes – CYP2C19, CYP2D6, and SLCO1B1 – accounted for 75 percent of the gene-associated reactions. These genes influence how the body processes drugs, including many commonly used psychiatric, cardiovascular, and pain medications.
Psychiatric medications alone accounted for nearly half (47 percent) of all potentially preventable ADRs. While most reactions were severe but non-fatal, some – such as cardiac arrhythmias – were fatal, although rare. Older patients were more likely to experience genetically linked ADRs, and these were more often reported by patients and carers than by industry. The study also found that psychiatric drugs were overrepresented in ADR reports compared with how often they are prescribed, suggesting a greater opportunity to improve safety through personalized prescribing.
The authors estimate that around 30 percent of these ADRs could have been avoided with the use of a pre-emptive genetic test, as shown in the European PREPARE trial. Coauthor Mark Caulfied said, “It is time for the National Health Service to consider adopting pre-emptive testing for known genes that interact with medications.”
The researchers argue that even a limited gene panel could have a major impact and help reduce healthcare costs, hospitalizations, and patient harm – particularly in psychiatry, where the need appears greatest.
As prescribing becomes more complex and polypharmacy increases with aging populations, the authors call for pilot programs to test real-world implementation of pharmacogenomics in UK healthcare.
Newsletters
Receive the latest pathology news, personalities, education, and career development – weekly to your inbox.
