Pharmacogenomic Test
Psycho-Pharmacogenomic Testing Services
“Point-of-Prescription” Real-Time Physician Support System
Cover 185 Drugs
Determine 100 Alleles in 27 Genes
Include Copy Number Variants
Introduction
Pharmacogenomic (PGx) testing identifies how your genes affect your response to medications. Getting a PGx test may help your physician adjust your medications to be more effective for you.
When you take a medication, your body’s response is determined by many factors, including your gender, weight, age, diet, other medications, any medical conditions, and exposure to environmental agents such as cigarette smoke.
Your genetic makeup can also have a major influence. In fact, genetic factors can account for up to 95% of how you respond to medications. Genes are sections of DNA, and variations in your DNA are what make you unique. The different versions of a gene you inherit from your mother and father can determine everything from your eye color to how quickly you process, or metabolize medications.
Depending on your genes, your body may break down a drug too slowly or too quickly. If you metabolize a drug too slowly, you may be exposed to too much of it, which may result in an adverse drug reaction (ADR). If you metabolize a drug too quickly, you may not get enough to have any effect at all.
Rainbow Pharmacogenomic test
Genetic factors can account for up to 95% of drug-response variability and susceptibility (1). In other words, how a drug will—or won't—work for a particular individual.
Recent studies have demonstrated that > 90% of patients possess clinically actionable genetic variants that affect their drug response (2, 3). The Rainbow Pharmacogenomic test can identify which inherited genetic variations a patient has to predict drug efficacy and metabolism and provide you with personalized recommendations for each of your patients.
The Rainbow Pharmacogenomic test is a cost-effective solution that determines how an individual patient’s genes may affect his/her response to medications. Our team analyzes a patient’s genetic information and provides a validated clinical test report to help physicians and patients to make more precise and effective prescription decisions.
The Rainbow Pharmacogenomic test covers 100 alleles, 27 genes, more than 185 medications, and 28 conditions.
Rainbow Psycho-Pharmacogenomic(TM) Testing Services
Enable physicians to improve outcomes of treatment-resistant or treatment-intolerant patients
By combining experience-based evidence with genomic-based drug response and adverse drug reaction profiles, psychiatrists can make informed decisions on choosing alternative medications.
Problems for patients and physicians
Suboptimal treatment responses including side-effects and lack of effectivity are common in psycho-pharmacology. For example, only 50% of patients respond to initial antidepressant treatment. Specifically, about 30%-50% of patients affected by depressive disorder, bipolar disorder, and schizophrenia do not respond to their first antidepressant. These non-responders have a 15% likelihood of suicide ideation, and insufficient treatment of psychosis could also manifest as violent and aggressive behaviors.
What to Do When There Are No Guidelines?
Most psychopharmacologic treatment guidelines emphasize first-line therapy selection, and not what to do when several options are ineffective or are not tolerated. Plus, only a handful of randomized, controlled trials of treatment-resistant or treatment-intolerant patients exist. In these situations of “no guidelines, no evidence”, physicians commonly rely on time-consuming, trial-and-error approaches (experience-based evidence) to choose alternative medications, delaying a desirable treatment outcome.
Integrative Psycho-Pharmacogenomics Strategy
Each individual possesses a number of genetic changes that can significantly affect the body’s ability to process a drug, resulting in different responses to medications. Pharmacogenomic testing categorizes two classes of drugs for each patient: drugs that can be taken at normal dosages with expected efficacy, and drugs that are likely to be processed slower or faster than normal, along with medications that can cause severe drug hypersensitivity reactions.
Our test enables physicians to combine drug efficacy data and patient tolerance profiles to rapidly select alternative psychiatric medications - achieved by simultaneous reduction in drug trial and error, and minimization of medication side effects.
Test Descriptions
Determines 100 Alleles in 27 Genes to Reduce False Negative Results
Alleles are different versions of genes. Asians carry certain alleles at much higher frequencies compared with other populations. To significantly reduce false negative results, a trusted pharmacogenomic test must be validated to determine sufficient alleles and genes specific to Asian patients. The Rainbow Pharmacogenomic test covers 100 alleles, including copy number variants (CNVs), in 27 genes specific to Asians, Caucasians, and mixed-race populations. Over 180 drugs are covered by the test. Most pharmacogenomic tests available in the market do not cover these numbers of alleles and genes, and CNVs are usually not tested, resulting in false negative reports.
During the office visit, your physician will also collect your DNA sample through a simple cheek swab. The sample will be sent to a U.S. CAP-accredited and CLIA-certified clinical testing laboratory. The clinical team will perform the testing, analysis and issue a clinical test report.
Clinical Examples
Example 1: CYP2C19 Gene Variations and Anti-Depressant Choices
Citalopram and sertraline are commonly used antidepressants in children and adults. Asian patients are twice as likely to have CYP2C19 *2 and *3 alleles compared to European and U.S. patients. The Asian patients are poor metabolizers, resulting in increased exposure (and side effects) for these drugs at the normal dosages. The Clinical Pharmacogenetics Implementation Consortium guideline recommends that doses of citalopram and sertraline for poor metabolizers be reduced by 50%, or the physician may select an alternative drug not predominantly metabolized by CYP2C19. The Rainbow test determines six alleles for the CYP2C19 gene, and confirms if the patient is a slow metabolizer. Simultaneously, the Rainbow test report recommends alternative antidepressant medications for which the patients can metabolize at a normal rate (for example, escitalopram at normal dose). The results enable physicians to make timely choices of alternative medications, or retaining original drug selection, but at the correct dosages according to current clinical guidelines.
Example 2: Importance of Comprehensive Testing CYP2D6 Gene Alleles
CYP2D6 enzyme by itself contributes to the metabolism of 25% of the most commonly prescribed medications including tricyclic anti-depressants, opioids, anti-psychotics, tamoxifen, cough suppressants and anti-arrhythmics. CYP2D6 gene variants (alleles) account for drug side effects in a large percentage of the general population. The Rainbow test comprehensively detects 42 alleles and copy number variants (CNVs) in the CYP2D6 gene.
“Point-of-Prescription” Real-Time Physician Support System
Our “Point-of-Prescription” Physician Support System enables doctors with no prior pharmacogenomic experience to quickly determine alternative medications in real time. The system also provides evidence of drug-drug interactions to improve prescriptions for patients who are taking multiple drugs simultaneously.
Is This Test Right For You?
Your test results can be used over the course of your lifetime to help you make better prescription decisions for many different medical conditions. While the Rainbow Pharmacogenomic test can provide insight for anyone, it’s particularly meaningful for patients who are taking:
MEDICATIONS THAT CAUSE UNWELCOME SIDE EFFECTS
MULTIPLE PRESCRIPTIONS
MEDICATIONS THAT ARE NOT WORKING
MEDICATIONS FOR ANY OF THE COVERED MEDICAL CONDITIONS