Pine Rest expands research

March 26, 2010
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Pine Rest Christian Mental Health Services is embarking on a study that represents the first step in boosting its clinical research efforts as part of Grand Rapids’ growing medical research community.

Clinical psychopharmacology specialist Kevin Furmaga is working on the study, which will examine whether medication response in depression patients is related to their genes.

“When you consider that people don’t respond or tolerate medications in a predictable way, a large part of the reason may be through genetics,” said Furmaga, who holds a doctorate in pharmacy.

The study, funded through the Pine Rest Foundation, Priority Health and genetic testing company AssureRx, of Cincinnati, Ohio, will test for five genes that regulate enzymes involved in metabolizing medications used for depression, he said. 

“If somebody is a poor metabolizer of a particular drug, normal dosing would lead to probably higher-than-expected blood levels, translating into more side effects or toxicity. On the other hand, somebody may be an ultra-rapid metabolizer, or metabolizes drugs faster than normal, and you would not expect to see a therapeutic response because therapeutic blood levels are not achieved,” Furmaga explained.

Genetic analysis would reveal variances in genes that impact enzymes involved as the body processes anti-depression drugs, he said.

“If we can, ahead of time, identify patients who are less likely to respond to a medication or more likely to develop toxicity or side effects to a medication, we can avoid those or make adjustments in the dosage to account for their genetics, and hopefully come out with a better outcome.”

The randomized, double-blind pilot study will compare outcomes for 200 patients who are genetically tested and have their medications tailored to the results with those undergoing routine drug treatment.

Study participants must be patients of Pine Rest clinicians, ages 18 to 80, have symptoms of certain severity, may not be using alcohol or other substances, and must be free of medical or other psychiatric diagnoses.

Priority Health, the Grand Rapids-based health insurer, has agreed to cover the $1,300 cost of AssureX genetic testing for any of its members who are study participants, Furmaga said.

“If you think about the time and expense associated with failed treatments or treatments that cause toxicity and side effects, it probably is financially worth their while to support it,” he added.

AssureRx was founded in 2006 to commercialize technology for personalized medicine, according to its Web site. The Mayo Clinic and Cincinnati Children’s Hospital Medical Center are partners in the company, both in equity shares and in technology collaboration. The company’s GeneSightRX test was given a full market launch last fall.

The federal Food and Drug Administration already requires genetic testing prior to prescribing for about two dozen medications. Furmaga said, and he thinks that will become more common.

“Genetic testing is definitely going to, I believe, become routine at some level in the near future, at least for some selected medications,” he said.

The opening of the Michigan State University College of Human Medicine in Grand Rapids has prompted Pine Rest to seek opportunities for clinical research, Furmaga added. He said this is the first Pine Rest study of which he is aware that falls outside the parameters of psychology.

“We are actively recruiting new research, as well,” he said.

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