The research interests of the Translational Initiatives for Pharmacogenomics (TIP) program at The Institute for Personalized Medicine (IPM) are two-fold. Primarily, we seek to develop and successfully implement best practices for the clinical adoption of pharmacogenomics and personalized medicine. In addition, we are actively engaged in multiple research activities that seek to enhance the evidence base needed for clinical translation of certain significant drug-gene interactions.
In education, we are working to bridge the knowledge gap that exists between researchers and clinical providers. We are accomplishing this with the inception of a pharmacogenomics elective rotation for PGY-1 and PGY-2 pharmacy residents, as well as volunteer opportunities for medical students and pharmacy students. We have developed an online training video that is available to our clinical providers, and educational brochures are available for interested patients. Discussions are ongoing for the development of a formal pharmacogenomics course for medical and graduate students at the Icahn School of Medicine at Mount Sinai. Learn more about Pharmacogenomics at Mount Sinai Health System.
Benefits of Personalized Therapeutics at Mount Sinai
Our patients are already benefitting from personalized therapeutics. Our locally developed IPM Pharmacogenomics (PGx) project and our multi-site NIH-funded eMERGE PGx project are on-going clinical research programs at the Mount Sinai Health System that utilize an advanced information management system developed by the Institute for Personalized Medicine named CLIPMERGE. More than 1,600 patients have already consented to participate in these projects, permitting their clinical providers to use their genetic information to guide the prescribing of medications such as clopidogrel, warfarin, simvastatin, codeine, and tramadol.
For example, in both the IPM PGx and eMERGE PGx, when a healthcare provider encounters an enrolled patient with a “high-risk” genotype and prescribes any of the medications listed above, a clinical decision support (CDS) is sent to the provider in real-time in the form of a best practice advisory (BPA) or an alert in the electronic medical record. The provider then has the opportunity to select from a list of alternative therapies that will potentially increase efficacy and/or minimize the risk for adverse events. Other medications under significant genetic influence that are currently being considered for the program include azathioprine, mercaptopurine, carbamazepine, phenytoin, abacavir, selective serotonin reuptake inhibitors (SSRIs), and tricyclic antidepressants (TCAs). A total of 220 physicians from Mount Sinai Internal Medicine Associates and Faculty Practice Associates clinics are currently participating in this program.