Dr. Shazhan Amed is a pediatric endocrinologist and a mother of two young children, so she’s no stranger to prescription medicines and their potential side effects.
Still, she was caught off guard when she received a common antibiotic for an infection and instead of feeling better, she started to feel worse: developing a painful, aggressive rash that quickly began to blister the skin all over her body, even melting the corneas in her eyes.
Within two days, she was admitted to VGH’s burn unit, where she spent a difficult month of recovery.
Shazhan had experienced a toxic drug reaction. Fortunately, this reaction was treated in time by multiple hospital specialists and the medical dermatology team at St. Paul’s Hospital.
“I know how fortunate I am,” Shazhan says. “My skin grew back and my vision returned. And with the help of my family, my community, and the MedSafe Clinic at St. Paul’s Hospital, I found my way back to my life.”
After Shazhan returned home to her family, doctors wondered: why did this happen? What antibiotics are going to be safe for her going forward? And how can we ensure this never happens to Shazhan – or anyone – again?
The answers lie in precision medicine.
What is precision medicine?
If you need glasses, you receive a customized prescription. If you need a blood transfusion, it must match your blood type. You can be allergic to one substance and not another. One size doesn’t always fit all.
Right now, most medical treatments are researched and designed based on common conditions that target the “typical” patient (what will work for most, not some) rather than tailoring to individual needs.
Yet treatments that are very successful for some patients don’t work for others. Even if patients have the same disease, its processes and mechanisms can play out differently.
Precision medicine supports the transition to more personalized patient-centred care, diagnoses and treatments where therapies are custom-built to meet individualized needs. Think of precision medicine as personalized medicine taken to another level.
Precision health takes a broader approach. It includes precision medicine, but also considers social, cultural, economic, and environmental factors, as well as disease prevention, to help people live healthy lives.
Doctors, researchers, and scientists take many aspects into account in precision medicine, including: genetics, health behaviours (diet, exercise, smoking, etc.), gut microbiome (the communities of bacteria in the digestive tract), clinical tests, and data (from multiple sources such as images, wearable devices, electronic health records, and biobanks).
Using precision medicine, health care providers can anticipate, prevent, diagnose, and treat diseases better. And patients feel more empowered knowing that they are getting personalized treatments tailored to their unique needs at the right time in their health care journey.
“The goal of precision medicine is to protect your health by measuring these factors and acting on them sooner,” says Dr. Darryl Knight, president of Providence Research; vice-president, research and academic affairs, Providence Health Care; and associate dean, research, faculty of medicine, University of British Columbia. “Then, interventions can be tailored to you.”
The growing field of precision medicine at Providence Health Care
After Shazhan’s near-fatal drug reaction, the MedSafe clinic at St. Paul’s began the painstaking work of extensive genetic testing to understand her and her family’s risk, since adverse drug reactions can be genetic. Her blood was tested for compatibility with other antibiotics so her frightening ordeal won’t happen to her again.
MedSafe worked in partnership with other hospitals to develop the most comprehensive, accurate panel of genetic testing for adverse drug reactions in British Columbia. Now, their goal is to get it out there in practice before reactions happen.
Other researchers at St. Paul’s who are advancing precision medicine include:
Dr. Bradley Quon is matching drug treatments to patients with rare genetic cystic fibrosis mutations to ensure everyone has access to the newest life-changing therapies.
Dr. Zachary Laksman is using stem cells to grow heart-specific cells in a petri dish. By recreating a patient’s specific cardiac disease and applying medicines to it, he can determine which drugs work best for each of us.
Dr. Mari DeMarco pioneered a first-in-Canada Alzheimer’s biomarker test, which can identify the early stages of the disease so patients can access treatments earlier.
Dr. Andrew Thamboo is working with the BC Cancer Agency to identify early markers of nasopharyngeal cancer, a rare cancer that grows in a hard-to-reach-area behind the nose.
Dr. Tillie Hackett discovered that damage from chronic obstructive pulmonary disease (COPD) starts much sooner than previously thought. This breakthrough allows researchers to develop new drugs that can treat COPD in its earliest stages, when the disease is reversible.
With precision medicine, we’ll be better equipped to provide more innovative treatments to patients and ultimately, help them live healthier lives.
The future of precision medicine: The Clinical Support and Research Centre
Innovation has always been a metaphorical bridge connecting patients with advancements in therapies and treatments. With the Clinical Support and Research Centre (CSRC), we will have a real bridge connecting to the new St. Paul’s Hospital bringing clinicians and researchers even closer to work side-by-side to change and improve the lives of British Columbians now and for generations to come.
With its state-of-the-art, purpose-built facilities, we are poised to move beyond mainstream treatments and propel precision medicine forward. The new St. Paul’s Hospital and the CSRC are being deliberately designed as the most data driven and digitally advanced medical campus in western Canada.
One of the keys to successful precision medicine is technology and artificial intelligence.
The CSRC will be home to robust networked biobanks, along with a highly advanced data centre. This will offer our researchers – and scientists worldwide – a swath of information needed to develop personalized medicine that cures disease, reverses its damage, slows its progression, or even prevents disease onset.
Using precision medicine, we have the potential to understand, define, and treat diseases better than before.
Whether a patient needs acute care or is managing a long-term condition, precision medicine enriches a physician’s ability to provide the optimal care. Or, in the case of people like Shahzan, to prevent a health crisis from ever occurring.
Providence cares for 628,626 patients annually. With the capacity of the new St. Paul’s Hospital and the CRSC, our team will have exponentially more opportunities to learn how to better serve each patient and improve the quality of their lives.
“Investing in precision medicine is the future of health care,” says Dr. Knight.
With precision medicine, doctors can protect our health with interventions that are custom-built, rather than using the exact same approach for everyone. Learn more about the life-changing research happening across Providence at the link below.