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Infectious Diseases

Updated 01 September 2020

Could genetics be the reason why some Covid-19 treatments work while others don't?

Many drugs are manufactured with a one-size-fits-all approach, including those being tested for Covid-19 treatment. Could genetics determine what will work and what won't?

  • When drugs are created, individual genetic markers are not taken into account.
  • A fairly new field called pharmacogenomics looks at tailor-made approaches to drugs.
  • Researchers now reckon this could work for Covid-19 treatments.

As the Covid-19 pandemic progresses, various existing drugs and remedies are being tested to stop the virus in its tracks and reduce mortality.

During the course of the outbreak, there have been glimmers of hope with drugs such as remdesivir and dexamethasone, while other treatments such as hydroxychloroquine proved to be ineffective against Covid-19.

According to researchers at the University of Minnesota College of Pharmacy, various drugs are currently being investigated, often without well-established data on safety or efficacy. But what if our genetics could provide a better understanding of which treatments might work?

Pharmacogenomics – a fairly new science

Pharmacogenomics is the study of how our genes affect our response to drugs.

Most drugs are manufactured using a one-size-fits-all approach, but pharmacogenomics combines the fields of pharmacology and genetics to develop safe, effective medications that are tailor-made according to a person's exact genetic make-up.

While this field is still new, experts believe a tailor-made approach can help find drugs for many conditions  including HIV, asthma, cancer and Alzheimer's disease  by looking at specific genetic markers. This could help to avoid interactions with some drugs that may cause unwanted side-effects and outcomes.

As complicated as that may sound, the researchers decided to scour databases for relevant literature to see whether pharmacogenomics could help them find the right Covid-19 treatment for every individual.

"The application of pharmacogenomic tests can help eliminate fatal hypersensitivity for patients prescribed certain drugs. We asked the question if selecting a Covid-19 medication or the dose using an individual's genetic information could improve effectiveness or safety," stated study author Pamala Jacobson in a press release.

What did the researchers look at?

The study, published in the journal Nature Genomic Medicine, is a comprehensive review of literature to determine whether pharmacogenomics can be applied to provide a safe drug for every Covid-19 case based on their genetics.

They looked at various drug therapies currently under investigation for Covid-19, including hydroxychloroquine, remdesivir, corticosteroids and tocilizumab and found the following key points:

-        There are several gene variants that affect the way the body processes some drugs used for Covid-19 drugs, which may lead to adverse effects.

-        The risks of taking these drugs for Covid-19 are currently complex and not clearly understood, as they may interact with medications that a patient is already taking for underlying conditions.

-        There is also a limited amount of data on pharmacogenomics and Covid-19 treatments because Covid-19 is still so new and clinical trials are only beginning.

"While we did not find direct evidence to support the use of pharmacogenomic testing for Covid-19, we did identify many actionable genetic markers that may have promise to improve efficacy and safety," said Jacobson.

"Clinical studies in patients with Covid-19 are needed before routine testing can be recommended."

READ | Scientists now able to identify 100s of potential Covid-19 drugs

READ | Remdesivir can save lives and shorten time in ICU, particularly in SA, researchers say 

READ | All about dexamethasone, which researchers say is a "breakthrough" Covid-19 treatment

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