Genetic factors predict drug behaviour
The study utilised the comprehensive Finnish drug purchase registry data. Such registers have only been collected in the Nordic countries.
Previous studies have identified hundreds or even thousands of risk genes for cardiovascular and other cardiometabolic diseases. However, the role of genetic variation on lifelong medication usage patterns has been largely unexplored.
“Our study showed that genes influence how people's drug regimens differ over a lifetime for cardiometabolic conditions such as hypertension and type 2 diabetes", said Tuomo Kiiskinen, a doctoral researcher at the Institute for Molecular Medicine Finland (FIMM) at the University of Helsinki, who conducted the study.
The results of the study are based on the FinnGen study, the Estonian Biobank and the UK Biobank. In total, the dataset covered about 650 000 individuals.
By looking at drug purchases from 1995 onwards, the researchers were able to build up a picture of how many of the participants had switched to another medication or stopped taking medication altogether. Data were also collected on the number of these drug purchases over a lifetime.
The results showed that more than three hundred gene regions were associated with these drug usage patterns. Most of these genes had previously been associated with the diseases in question, but there were also previously unidentified risk factors.
The researchers also developed a new genetic algorithm to predict the need to switch to a more effective medication and for stopping medication use.
Currently, treatment is initiated based on clinical variables, but there are wide variations in the effectiveness and suitability of drugs. Genetics has therefore been proposed as a tool for optimising drug therapy in the future.
“The results show that genetics strongly predicts the use of these commonly used medications. For some individuals, their genome would also tell them which cholesterol drug would suit them best, without the need to test the suitability of different drugs one by one", says Professor Samuli Ripatti from the University of Helsinki, who led the study.
The results of the study were published in Nature Medicine.
Genetic predictors of longitudinal medication use profiles in dyslipidemia, hypertension and type 2 diabetes. Tuomo Kiiskinen, Pyry Helkkula, Kristi Krebs et al. Nature Medicine 2023. https://doi.org/10.1038/s41591-022-02122-5