MEDICINE TO FIT YOUR GENES
August 26, 2005
The Food and Drug Administration's (FDA's) approval of the heart drug BiDil marks a new understanding of health disparities, say John J. Cohrssen and J. Donald Millar of the Public Health Policy Advisory Board. As a drug specifically for African Americans, its approval signals that the FDA at least recognizes genetic differences make subpopulations more or less likely to succumb to specific diseases or to benefit from particular treatments.
Cohrssen and Millar believe genetics may explain why the frequency of specific diseases in the United States varies by geographic region as well as race and gender. Genetics also may unravel some of the causes of disparities in health status from country to country. Consider:
- Whites are more likely than Asians or African Americans to have abnormally low levels of an important enzyme that metabolizes certain drugs, such as antidepressants, antipsychotics and beta blockers.
- Japanese women on average live almost 85 years, five more than American women, and Japanese men on average 78 years, four more than American men (Asian Americans also have death rates lower than White Americans).
- U.S. infant mortality rates exceed most Organization for Economic Cooperation and Development countries at 6.8 per 1,000 live births, far higher than Iceland, Japan, Finland, Norway, Sweden or Spain, whose rates are under 4.0.
The ultimate goal is to help tailor medicines to a patient's unique genetic make-up for greater efficacy and safety and the U.S. government has made the reduction of health disparities a priority.
However, the recognition of biological causes of health disparities associated with race and ethnicity raises fears that these differences will be used to discriminate against minorities rather than benefit them. Yet, Cohrssen and Millar say ignoring biology can only limit the understanding of why certain people get sick and how best to treat them.
Source: John J. Cohrssen and J. Donald Millar M.D., "Medicine to Fit Your Genes," Tech Central Station, August 5, 2005.
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