DNA testing in primary care 'will transform treatment and cut costs'

Genotype-guided dosing of warfarin in primary care can improve patient outcomes and slash NHS spending on anticoagulants, according to a genetics expert.

Professor Sir John Burn (Photo: Pete Hill)
Professor Sir John Burn (Photo: Pete Hill)

Clinical geneticist Professor Sir John Burn told GPs at the 2014 RCGP annual conference in Liverpool that the breakthrough could transform prescribing in primary care, as point-of-care DNA testing becomes cheaper and more convenient.

Professor Burn, from Newcastle University, said it was now possible to test a patient’s genetic sensitivity to warfarin within 20 minutes for just £20, and the technology could soon be available in primary care.

The same machine will let the GP know the correct dose of warfarin for a patient.

Professor Burn said this would greatly improve outcomes. ‘It’s like saying, don’t buy shoes until you know what size your feet are. You wouldn’t just take away a size seven and hope it fits,’ he said.

‘There are two genes involved in warfarin metabolism. We know that there are three very common variants [of these genes] in our population. If you test for those three variants, you can accurately predict people’s [required] dosage.’

Recent NICE guidance for AF recommended wider use of novel oral anticoagulants (NOACs) as alternatives to warfarin, which requires regular monitoring and is difficult to dose correctly.,/p>

But there are fears this is driving up NHS spending, as these treatments are estimated to cost more than three times the price of warfarin.

‘We can't afford to put everyone on NOACs and we don’t need to,’ said Professor Burn. ‘What we’re trying to do is demonstrate that warfarin can continue to be used if you genotype people.’

Professor Burn and his team have started to roll a scheme to trial point-of-care testing and genotype-led dosage adjustment in Newcastle.

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Register

Already registered?

Sign in

Follow Us:

Just published

MPs demand urgent action on NHS backlog and routine COVID-19 tests for staff

MPs demand urgent action on NHS backlog and routine COVID-19 tests for staff

MPs have demanded urgent action to prevent avoidable harm to patients from the NHS...

Freeze QOF and deliver COVID cash or second wave will overwhelm GPs, BMA warns

Freeze QOF and deliver COVID cash or second wave will overwhelm GPs, BMA warns

GP practices will be unable to cope with a second wave of COVID-19 unless urgent...

Reducing our practice's carbon footprint by appropriate inhaler prescribing

Reducing our practice's carbon footprint by appropriate inhaler prescribing

Dr Vasu Siva explains how her practice is aiming to cut its carbon emissions by targeting...

RCGP chair warns of 'significant problem' over flu vaccine supplies

RCGP chair warns of 'significant problem' over flu vaccine supplies

The NHS faces a 'significant problem' with flu vaccine supplies as it aims to cover...

GMC overhauls consent advice to improve patient involvement in decisions about care

GMC overhauls consent advice to improve patient involvement in decisions about care

The GMC has overhauled its guidance on patient consent - setting out seven key principles...

Government must show evidence behind PPE strategy, warns BMA

Government must show evidence behind PPE strategy, warns BMA

Chronic shortages of personal protective equipment (PPE) across the NHS during the...