Thomas Young Prize Lecture 2019 – Professor Sir Munir Pirmohamed

Published: 13 December 2019

This year’s Research Day culminated with the Thomas Young Prize Lecture, given by Professor Sir Munir Pirmohamed, David Weatherall Chair in Medicine at the University of Liverpool. As well as being a consultant physician, Professor Pirmohamed also holds the prestigious titles of NHS Chair of Pharmacogenetics, Director of the MRC Centre for Drug Safety Sciences, and Director of the Wolfson Centre for Personalised Medicine.

After a day of inspiring presentations from staff, showcasing the best research from across the University, it followed for Professor Pirmohamed to close the event with his talk, “Precision medicine: do we need it?”, explaining why he believes precision medicine is so important.

Treatments need to be more effective and safer

Firstly, Professor Pirmohamed discussed the huge costs involved in bringing drugs to market. Outlining that it costs approximately $1.5 billion per drug once accounting for failures, he believes it should be expected that the drugs doctors have at their disposal will work in the majority of patients. However, this isn’t always the case.

“Most drugs only work in 30-50% of people,” he said. “If you go out and buy clothes, you wouldn’t buy something that doesn’t fit. You’d buy the precise fit.”

This is the approach he believes is needed to take with drugs, highlighting that researchers need to think about how to improve the success rates of medicines.

He added,

“Precision medicine provides a way to not only develop new drugs, but also repurpose existing ones so we can make them work better and for different conditions.”

The other key issue, was that of safety. With it known that 6.5% of hospital admissions come from adverse drug reactions, Professor Pirmohamed believes more needs to be done to make sure the drugs we give don’t result in further hospitalisation.

“Right now, 8,000 NHS beds are occupied by patients with adverse drug reactions,” he said. “If each hospital has 800 beds, that’s 10 hospitals-worth of people”. Professor Pirmohamed added that not only is this detrimental to the patients being treated, but is also hugely costly for the NHS.

The hope is, that precision medicine could help to reduce the burdens of ineffective and potentially unsafe medicines. The mantra of giving the “right treatment, with the right dose, to the right patient, at the right time, for the right outcome”, is central to Professor Pirmohamed’s ambitions for the future of precision medicine.

Precision medicine is on its way

Professor Pirmohamed then went on to explain the myriad of ways in which precision medicine is becoming a reality, from cancer treatment to other diseases.

Highlighting the recent announcement by the health secretary, Matt Hancock, that all new children will be able to have their genome sequenced at birth, Professor Pirmohamed was able to demonstrate the implications this could have on prevention and treatment of disease. He cautioned that potential ethical issues around this would need careful consideration, especially around informing those who have the potential to develop life-changing conditions like Huntington’s Disease.

Professor Pirmohamed was also able to talk about a number of technologies that could pave the way for personalised treatments in future, including gene-editing using CRISPR technology.

“This work is becoming transformational,” he said, while explaining recent work that used viral vectors for gene therapy to treat haemophilia. He added that these new treatments could become cures, and that many other diseases, such as sickle cell disease, are now also amenable to being treated with gene therapy.

Professor Pirmohamed finished with his vision of the future. “At the moment we use our iPhones for GPS navigation, but in 50 years’ time, I think GPS will mean Genomic Prescribing System,” he said.

“We’ll be able to carry our whole genome on the phone, it will be linked to our health records and will have sensors, not only on the phone, but others you may be carrying or wearing. You’ll then be able to hand the phone to your doctor, who will prescribe your treatment based on your genome and other factors.”

According to Professor Pirmohamed, precision medicine is here to stay, and the future of medicine will depend on how the new advances are managed.