What is pharmacogenetic testing?
Depending on your genetic makeup, some medications may work more effectively, less effectively or cause side effects for you. Our pharmacogenetic test detects genes that affect the way medications work within your body. Your genetic results are then combined with the best evidence to help you and your healthcare professional select the best medication and dosing for you.
Learn more about pharmacogenetic testing in our Education Center.
What is DNA?
The human body is composed of trillions of cells, each with specific functions and roles. But how are these functions and roles coded? How does each cell know what to do?
Deoxyribonucleic acid (DNA) is a molecule found within the nucleus of all cells, packaged in chromosomes, and holding the information required by a cell to function. DNA is made up of four chemical bases called adenine (A), thymine (T), cytosine (C) and guanine (G) and their order within DNA provides instructions for making proteins. ..In addition to acting as a set of instructions, DNA also acts as the hereditary material that is passed down from parents to their children and is why children share similar traits with their parents.
Specific sequences of DNA, called genes, contain directions for how to build a particular protein. Proteins are responsible for nearly everything that happens in the body from determining eye color to breaking down medications. For example, a gene called CYP2D6 encodes for an enzyme called Cytochrome P450 2D6 which is responsible for the metabolism and elimination of approximately 25% of clinically used medications.
Each human cell contains billions of DNA bases and about 20,000 genes, which are collectively referred to as a genome. More than 99% of our genomes are the same, but variations do exist among people. The most common of these variations are called SNPs (Single Nucleotide Polymorphisms).
A SNP is the difference in a single DNA base at a particular location. For example, at a position of a gene the base C is the most common among a group of people, but in some individuals the position is occupied by base A. There are approximately 10 million SNPs in the human genome and most of these SNPs have no effect on the cell or on your health. However, a small number do affect the body and some SNPs affect how individuals respond to certain medications.
Another type of genetic variation is called CNV (Copy Number Variants), which occurs when the number of copies of a particular gene varies from one individual to the next.
Who can benefit from TreatGxPlus?
One size does not fit all. TreatGxPlus help you and your healthcare provider tailor your medications to your unique genetic makeup and health profile if you are:
• Living with a chronic condition;
• Taking multiple medications;
• Living with drug sensitivities and allergies;
• Living with hepatic and/or renal impairment;
• Struggling to find an effective medication;
• And more.
See the list of all the conditions and medications covered in TreatGxPlus here.
TreatGxPlus includes a genetic test for a medication I am taking, but I have a different condition than the one listed with the medication – why is this?
Most gene-drug interactions are discovered in a group of patients with the same condition. This is especially true when trying to predict who will respond to a medication and who may not. When we talk about “response”, we need to know whether we are talking about preventing disease, improving symptoms, curing a disease, or slowing progression of a disease, and this depends on what condition the medication is treating.
Generally, researchers will looks at a group of patients who have had a good response to a medication for a particular condition, and compare their genetics to a group of patients who had a poor response to the same drug for the same condition. The researchers look to see if there are any genetic variants that are associated with only one of the groups, either those who had a good response or those who had a poor response. If they find a genetic variant that meets these criteria, they could say that having this particular genetic variant may predict whether you will respond to this medication or not. However, this is looking at response to a particular medication while treating a particular condition. If a medication is used for a different reason in another condition, this genetic variant may not predict response to this same medication in a different condition. This is why all of our medications in TreatGxPlus are associated with a condition; some medications may be associated with several conditions, but we do not predict response to a medication in a certain condition if it has not been studied.
An exception to this would be for genetic variants associated with adverse drug reactions, which are relevant to all uses of a medication and are reported regardless of the condition.
How you can manage your health
TreatGxPlus equips you and your health care professional with a software tool that can swiftly provide medication options based on your genetic profile, strengthening your ability to make informed decisions to improve your health.
Always consult your healthcare professional before starting, changing, or stopping medications.
Remember, medication is only one part of treatment; lifestyle changes including eating healthily and keeping active are vital aspects of managing your health.
What unexpected things might I learn from pharmacogenetic testing?
GenXys testing has no incidental findings as the analysis is directed at the specific areas of the gene necessary to identify medication/gene interactions. Unlike other genetic tests, our test is designed to inform your medication choices. Our test will not inform you or your physician of diseases that you might get, for example cancer, vascular disease or Alzheimer’s.
Can ancestry be identified with the TreatGxPlus pharmacogenetic test?
No, the TreatGxPlus service does not help identify your ancestry. Unlike other genetic tests, the TreatGxPlus service is designed only to tell you about your medication choices
Can pharmacogenetic testing identify increased risk of certain medical conditions?
The TreatGxPlus service helps you make better medication choices by identifying only those areas of your genes that interact with medications.
The test will not inform the risk of disease, for example; cancer, vascular disease, or Alzheimer’s disease.
How does TreatGx decision support work?
TreatGx generates medication options that are safe and effective for you by combining your genetics with up-to-date clinical evidence and information that you enter. TreatGx has been developed to facilitate the shared decision-making process between you and your healthcare professional. With TreatGx, you are able to access and update your personal information while viewing the effect this has on medication options, thereby strengthening your ability to make informed decisions about your health.
For more information on how to use TreatGx, please visit our Help Center
How are the algorithms developed for each condition?
• Each TreatGx algorithm takes approximately 400 hours to be developed and tested by a team of physicians, pharmacists, geneticists, epidemiologists and other healthcare professionals.
• The TreatGxPlus team uses the highest levels of clinical evidence available. Evidence from high-quality guidelines, systematic reviews, drug interaction databases, genotype interactions, product monographs, and randomized controlled trials are combined and presented to an expert panel.
• The final medication options are optimized for each patient, determined by a set of factors including the clinical stage of the disease, the biophysical profile of the individual (age, gender, renal function etc.), concurrent medications, and the results of their pharmacogenetic test.
• This process is iterative and constantly updated with new, emerging evidence.
How to place an order
In Canada, TreatGxPlus is brought to you in partnership with LifeLabs. To order, please visit the LifeLabs genetics website.
How do I give a sample?
Taking the test is easy! Once you receive your kit, follow the instructions and swab the inside of your mouth using the soft sponge. After registering your kit online, you mail it back to the GenXys lab using our prepaid return envelope.
Log into your account and select ‘Invite your clinician’ from the Navigation menu. In this page, you can enter the email of the healthcare provider you would like to invite to view your results or find a clinician in our system. Once you find the name of your healthcare provider, click ‘+ Add’, and an invitation will be sent.
For more information on how to use TreatGx, please visit our Help Center
Receiving and viewing my results
Your pharmacogenetic information is securely transferred to your account where you can generate your individualized medication options. Once you log into your account, you will use a series of drop down lists to enter information about your health status. This information may include your age, weight, liver and kidney function. After filling the required fields, TreatGX will display personalized treatment options specific to you and your condition.
What conditions are included in TreatGxPlus?
TreatGxPlus starts by considering your patient’s condition, disease state or diagnosis.
See the list of all the conditions and medications covered in TreatGxPlus here. TreatGxPlus is continuously expanding and new conditions are being developed regularly.
I am trying to confirm that a prescribed medication is appropriate for my patient, but it is not coming up as an option. Why not?
Consult your healthcare provider
• TreatGxPlus is intended to be used as a decision support tool when modifying medication therapy. The software assumes the current therapy is ineffective or not tolerated and offers the next line of medication options.
o If you would like to use TreatGxPlus to check the dosing for a medication or its appropriateness for a patient, please remove the medication from the current medication list.
• All our medication options are evidence-based and it may be that new evidence has shown the prescribed medication is now a second or third line option
• The medication may not be appropriate
Is monitoring information included?
• Monitoring will continue to be done by your healthcare provider.
• Occasionally monitoring may be given for follow up. For example, we recommend monitoring renal function every 3-6 months for patients on metformin with declining renal function.
• All absolute contraindications and severe drug-drug interactions with strong evidence are included.
• The monitoring of the following are not included and are the responsibility of your healthcare provider:
o Additive side effects from multiple medications (ie. anticholinergic effects, QT prolongation, or electrolyte imbalances)
o Interactions with low levels of evidence
o Medication response
o Adverse reactions
I am not getting the result I was expecting. Please help!
Consult your healthcare provider
• Please ensure that all your information has been entered correctly, particularly the “Drug History”, “Medication History” and “Current Medications” sections.
• TreatGxPlus is evidence-based. While we do our best to incorporate popular prescribing practices within the system when applicable, we have excluded some medications or have moved them to second or third line options in accordance with the evidence. Any questions can be directed to firstname.lastname@example.org
• A “Seek Specialist Advice” may appear alongside drug options. This is often due to numerous contraindications, drug interactions, complexity of drug regimen or severity of disease. It may also be due to monitoring required for the drug, or there may be non-drug therapy that specialists can provide. Please consult your healthcare provider for further instructions.
List of Abbreviations used in the TreatGx software
Here are some common abbreviations used in the TreatGx software.
DS Double strength
EC Enteric coated
DPI Dry powder inhaler
pMDI Powdered metered dose inhaler
SC Subcutaneous injection
IV Intravenous injection
IM Intramuscular injection
IBW Ideal body weight
To learn more about pharmacogenetics, levels of evidence, pharmacokinetics, pharmacodynamics, and more please visit our Education Center.