Personalized Medicine

The FDA recently approved Nitromed's BiDil for the treatment of heart failure in American Blacks. This has turned out to be a controversial decision as it seems to contradict the [inaccurate] belief that there are no biological differences between ethnic groups.

Comments

[Brian King]

it does seem like more of a marketing decision than a medical one. "no biological difference" between ethnic groups may be too strong a statement, but it's also true that there's as much genetic diversity within groups as between them, so you probably can't predict a drug's benefit from superifical characteristics like ethnic origin. there may be some genetic features common in sub-saharan people that predispose them to a certain type of heart failure, but you couldn't tell if those features are present in an individual just by skin color for example - you'd have to have a genetic test.

also, in the americas you can not tell much about the likelihood of having particular ethnically linked genetic traits by a person's appearance. This article (http://www.backintyme.com/Essay040608.htm) claims that "About one-third of White Americans are of between two and twenty percent recent African genetic admixture". I can't vouch for the accuracy, but I've read similar things elsewhere, and that the percentage of european genetic features in americans who appear ethnically african is higher. the few genetic traits that relate to appearance have remained segregated, but the greater number of deeper traits that might be linked to disease are mixed freely among american ethnic populations.

[Angsuman Chakraborty]

It could be just the tip of the iceberg.
The old model of large-patient-population, small-molecule medicine is gradually shifting more and more toward large-molecule, small-patient-population therapies. The day may even come when individualized therapies will become common.