Genetic make-up could be the key to fewer side effects from IBD drugs

What the research is looking at? 

 Side effects from immunosuppressant drugs (such as biologics, thioprines and 5ASAs) are common in people with IBD, but are usually mild. However, in some people, they can be severe and lead to problems such as kidney damage, nerve damage, and failure to produce bone marrow properly. 

Scientists aren't sure why these immunosuppressant drugs have such harsh effects in some patients, but not in others. This means that doctors cannot predict which patients will develop serious side effects - so all patients on these drugs have to go through regular testing and monitoring to spot any serious side effects at an early stage. 

Research in other areas of medicine has suggested that genetic factors may be responsible for adverse drug reactions. That is, that people with a particular genetic makeup (specific genes in their DNA) may be more at risk of experiencing these side effects. So the aim of this research is to try and identify which particular genes may be linked with strong adverse reactions to drugs commonly used for IBD. If it is successful, then doctors may be able to develop predictive tests to identify, even before they start treatment, which patients are more likely to have adverse reactions. Then, for high risk patients, monitoring could be intensified or other drugs used instead, while for low risk patients monitoring can be relaxed. 

The research is looking at five adverse reactions to drugs commonly used in IBD. The researchers hope to carry out a national study with the help of other gastroenterologists across the UK. 

Conclusions 

This study has successfully identified several genes that increase the risk of people with IBD developing serious side effects such as pancreas damage and reduced bone marrow function, when given immunosuppressive medication.  Researchers hope that their findings will soon enable doctors to use predictive tests to avoid their patients experiencing serious side effects. 

What do researchers think this could this mean for people with IBD? 

The researchers hope that once these predictive tests are properly developed, patients will have a simple blood sample taken before starting drug treatment, which will be tested for the presence of these particular genes. If the results of the test show low risk of developing serious side effects, doctors may decide to decrease monitoring. If the results show high risk, doctors may choose to reduce the dosage, increase monitoring or choose a different course of treatment altogether, all in an effort to improve patient safety.  

Who's leading the research: Dr Tariq Ahmad, Royal Devon and Exeter NHS Foundation Trust 
Our funding: £106,298 over 24 months. 
Official title of the application: “Investigation of the genetic factors determining adverse drug reactions in patients with IBD.”
Tags: Drugs / Genetics