When we take medicine, we expect it to help but the same drug that eases one person’s symptoms might not work for another.
Abdullah Al Maruf, assistant professor of clinical pharmacogenomics at the college of pharmacy, studies this difference. Maruf said, “I am a pharmacist by training. It struck me early in my career that there are significant differences in how we respond to medicines.”
His research examines the impact of genetic variation on how people respond to medication, particularly drugs prescribed for mental health conditions such as depression and anxiety.
“We want to make sure medicines are […] safe and effective,” said Maruf. Pharmacogenetic testing can help us predict whether a person will likely benefit from a drug, or whether the dose needs to be adjusted, he explained.
In Maruf’s Pharmacogenomics Knowledge to Action (PGxK2A) Lab, the team works to “facilitate” the evaluation and implementation of evidence-informed genomic precision medicine.
More recently, he launched the Precision Medicine Research and Education Hub (PRECISE CARE HUB), dedicated not only to advancing pharmacogenomics, but also to engaging the public and health care providers in conversations about mental health and medication.
“Mental health itself has stigma, so nobody wants to talk about it. Nobody wants to share which drug they are taking, let alone [inquire] if it is working or not,” Maruf noted. “So, we are trying to build a research hub where the purpose is not only to do research, but also to educate people.”
PRECISE CARE HUB is envisioned as a provincial resource and a space where patients, families and clinicians can learn, ask questions and feel supported. Advisory councils made up of people with lived experience help shape the research by identifying priorities and barriers in treatment.
“Collaborating with youth and their caregivers with lived or living experiences with mental disorders […] is an eye-opening experience, as patients or the public can give us input and share perspectives that, as researchers, we commonly miss,” Maruf observed.
PGx-SIMBA is another ongoing study that is recruiting participants between ages 6 and 24.
“We are investigating whether interindividual genetic variation can explain why some children and youth develop antidepressant-induced behavioral adverse effects while others do not,” he explained. The study compares genomic profiles between those who respond well to medication and those who do not. The aim is to provide “a genetics-based tool to aid clinicians in identifying the kids at risk of developing these adverse effects from these drugs and subsequently personalize their treatment plan.”
Another initiative by Maruf and his team focuses on communication. His team found that patients often have unrealistic expectations and receive unclear explanations about genetic testing. In response, they developed the Pharmacogenomics Communication Tool, which will be published soon. The tool contains best practices for health-care practitioners on how to discuss testing processes and results with patients before and after testing.
Maruf wants to see pharmacogenomic testing become routine in health care, such that test results stored in medical records follow patients across the province.
Right now, it can take approximately 20 years for discoveries to reach the clinic. He highlighted that his team is “among the few groups in Canada working to bring this innovative approach, ‘gene-guided medication therapy,’ to daily clinical practice.”
Maruf explained that he regularly receives emails from patients who have used the testing. Many shared that it helped them select the right medication or dosage, while others expressed relief at finally understanding why a particular drug was not suitable for them. “For a scientist, it is a dream come true to see you facilitating something that has made a real impact on patients,” he said.
For Maruf, the research is ultimately about making medicine more personal and precise. “I hope one day we can all have the option to have our genomes sequenced after birth, and the results (with updates) can be stored in our medical records to guide medication therapy when we need them,” he noted.
Encouraging student researchers, Maruf said, “reach out and ask questions […] If you are interested in pursuing graduate studies in pharmacogenomics, reach out to professors who work in this area (like me).”