Jun: Clinical Implementation Pilot: Preemptive Pharmacogenomics (PPGx) Testing in Singapore
Recap key insights from June's CRIS Connect Webinar:
The webinar spotlighted the Pre-emptive Pharmacogenomics (PPGx) Clinical Implementation Pilot (CIP) funded by Precision Health Research, Singapore (PRECISE), where speakers shared the basis, implementation, and application of PPGx in Singapore.
The pilot is in progress to facilitate the implementation of PPGx testing in clinical practice, including demonstrating usefulness of PPGx testing in improving outcomes and eliminating logistic barriers and improving workflows to reduce cost.
Presently, the PPGx CIP has demonstrated the feasibility of scaling pre-emptive PGx testing across seven institutions and more than 2,000 patients. By integrating structured test results into clinical decision support systems, the pilot study has enabled genotype-guided prescribing and real-world changes to prescriptions. Key enablers included strong clinician leadership, top-down management support, robust informatics infrastructure, targeted training and administrative frameworks for systemic change.
Importantly, the pilot has also laid the foundation for validating Asian-specific PPGx variants, positioning Singapore to lead in regional discovery and translation. These insights will be crucial in informing the upcoming Phase III of the National Precision Medicine programme, which aims to scale PPGx implementation nationally.
The speakers also emphasised the broader context of precision medicine which stratifies patients by genetic, environmental and lifestyle factors. Findings from the SG10K study are already revealing population-specific risks, from adverse drug reactions to dosing sensitivities, highlighting the clinical and system-level impact of embedding PPGx testing into routine care.
Specifically, Dr Wan Yi Min, Senior Consultant Psychiatrist at Ng Teng Fong General Hospital, shared a use case about a patient diagnosed with major depressive disorder. The prescription had caused the patient to experience side effects such as emotional numbing, excessive drowsiness and reduced functionality. Through the PPGx pilot, the patient’s DNA was sequenced and Dr Wan was provided with a report highlighting how the patient’s genetic makeup would cause potential issues with dosing, medicine efficacy and side effects. This enabled Dr Wan to adjust the medication and optimise the dosage based on the patient's genetic profile. The revised and tailored treatment led to significant improvements as the patient regained emotional well-being and renewed interest in life.
The PPGx approach, not only enhanced treatment effectiveness but also empowered the patient with better-informed decisions. On a larger level, this offers clearer, more scalable benefits than the often-misinterpreted “personalised medicine.”
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