H. Robert Superko, M.D., presented data on genetic polymorphisms (SNPs) and cardiovascular disease. The boosters of comparative effectiveness research are pushing government policy away from personalized medicine. After listening to Superko’s presentation I am convinced that this is the wrong direction to go.Two examples:
The KIF6 variant predicts statin responsiveness. In the PROVE IT trial, NNT for intensive statin benefit was 10 in carriers, 125 in non-carriers!
A variant of the LPA gene is a powerful predictor of aspirin responsiveness (NNT 37 vs. 400!).
2 comments:
Maybe I have more of a european perspective but our clinical trials regs are pushing genetic components in trials for the powerful examples you have given. Look forward to more on this if you get a chance. I'm interested in compiling a list of these genetic predictors - know any good sources? Thanks
A broader view of personalized medicine goes beyond genomics and just asks “what is best for me?” But, this can conflict with population based studies especially when cost is emphasized.
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