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Https://www.genomicseducation.hee.nhs.uk/blog/post-stroke-and-mini-stroke-prescribing-comments-sought-by-nice/

Personalised care to thousands’

Genomic testing can show if a patient carries one of the CYP2C19 variants that affects if clopidogrel will work well for them. “Recommending a genetic test that can offer personalised care to thousands of people who have a stroke each year will be a step forward in ensuring people receive the best possible treatment,” said NICE’s chief medical officer Professor Jonathan Benger. The Stroke Association’s chief executive Juliet Bouverie added: “Getting on the right medication and taking it as advised can really go far to prevent further strokes.” She also emphasised that patients who have not had a genomic test should not assume that their current medication isn’t working: “If you have been prescribed clopidogrel, you need to keep taking it. If you’re worried about your risk of another stroke, you should speak to your doctor.”

NICE’s consultation in genomic testing for patients who have had an ischaemic stroke has highlighted how point-of-care pharmacogenomic testing is entering the clinic. If you’re a pharmacist or a pharmacy technician who wants to learn how genomics is impacting your work, then check out this free eLearning tutorial into pharmacogenomics.

There is lot of movement on HTE6 (MT - RNR1 ID Kit) documents from past few days which is not before , so some update is dew ..

Has the stake holders list updated last night ??

https://www.nice.org.uk/guidance/hte6/documents/stakeholder-list

Scavengers are here … sewer rats :-)

Thank you Stephen , Constructive criticism is welcome but people like Roger and Slacker out here lot of nonsense :-)

Https://www.investments.halifax.co.uk/research-centre/news-centre/article/?id=16542715&type=bsm

Global cases 77 million .

Very good article , it says further funding already applied ???

Can someone go through this again and clarify this part .

“With MT-RNR1 getting a NICE EVA conditional recommendation last year, further funding applied for to achieve a full recommendation this year, a strategy in place to achieve FDA approval and sales being realised from new customers in 2024 we feel there is growing momentum within the group's POC pharmacogenetic testing strategy.”

*Dew

Dr John McDermott posted below on Linkedin on the day NiCE published guidance .I believe the next set of news is CE IVD certification which is few any min.

The headline recommendation is that CYP2C19 genotype testing should be used to assess if clopidogrel is a suitable antiplatelet for people who have just had an ischaemic stroke or TIA.

If adopted into routine practice, this represents a major transformation in the way we manage stroke in this country.

Some key points 👇

- There are an estimated 110,000 strokes and TIAs in the UK each year and the first line treatment for a majority of these is clopidogrel.

- Clopidogrel needs to be activated by the CYP2C19 enzyme - but a significant proportion of the population carry loss of function (LoF) variants in the CYP2C19 gene which reduce the activity of this enzyme.

- These individuals are at increased risk of secondary vascular events, which is why NICE has made this recommendation, suggesting alternative antiplatelets could be used.

❓ But how do we actually deliver CYP2C19 genotype testing for all the patients who are eligible?

- CYP2C19 genotype testing (and pharmacogenetics more broadly) is fundamentally different from most of the genetic testing we currently

deliver.

- Unlike with most rare disease and cancer tests, CYP2C19 results are required rapidly and used by professionals who may not have experience of handling genetic data.

- Lab testing will form a part of any strategy, but pathways must be established to 1) transport samples to specialist labs, 2) deliver testing at speed and scale, and 3) return results in a clinically relevant format to clinicians who can action these.

- This last point is critical. Many stroke centres operate a "hub and spoke" model, where patients are admitted to a hyperacute specialist centre (the hub), before being repatriated to their local centre (the spoke) for ongoing care.

- If the lab CYP2C19 test has been requested in the "hub" and the patient is repatriated, how do we ensure these results are returned to clinicians caring for the patients in the local centres. This is logistically and administratively challenging, to say the least.

- One alternative would be to adopt a mixed model of genotyping, with rapid point of care testing strategies sitting alongside lab testing.

- With that in mind, NICE has recommended the genedrive CYP2C19 ID kit as the first line point of care test. This can identify CYP2C19 genotype in ~1 hour from a cheek swab.

- We're currently undertaking a verification of the system here at MFT Research and Innovation for CE-IVD certification as part of the Innovate UK funded DEVOTE programme.

Lol Roger , POC is used where lab testing is not possible because of time critical … Why do u think doctors go for lab testing before the use of Clopidogrel on emergency patient ??

I know you are not well, I wish you speedy recovery and all the best Roger .

Please read below ,If you are not sure what this test is all about …

Clopidogrel is a prodrug that can be converted (metabolised) to an irreversible P2Y12 inhibitor with antiplatelet properties. Clopidogrel is given after Ischaemic stroke or transient ischaemic attack to reduce the risk of further occlusive events, such as another stroke.

The CYP2C19 gene encodes a protein that is needed to metabolise clopidogrel to its active form. Clopidogrel may be less effective in people with particular variants of this gene, who may benefit from use of an alternative antiplatelet therapy. CYP2C19 genotyping enables identification of variants in the CYP2C19 gene. This provides information on how effectively a person Clopidogrel genotype testing after ischaemic stroke or transient ischaemic attack can metabolise clopidogrel and therefore can be used to guide antiplatelete

treatment.

@latino , lol indeed they are :-) …

@slacker , any investor with a right state of mind come here talk ****e about the company they are invested , you always come out with negative nonsense , if you 100% certain the price go down and they raise at 2p why dont you sell out and buy back in at lower , you had a chance to sell at 9p last week too , and all this new posters no nothing about the company, nothing but a small scale shorting firm ..

A coordinated attack , shorters like slacker and Mjwandco etc and a new addition porky :-) … drawing their own conclusions about the equity raise and the price … all your shorts burn soon ..

Good point @Gloria ..

Anyone spotted below comment before or it is a new comment ?

“ The summaries of the clinical and cost effectiveness are reasonable interpretations of the evidence, and the recommendations that have been made around collecting further data in smaller non-specialist centres and outside of neonatal intensive care units, including in centres where babies will come from different patient demographics (such as different ethnicities and socio-economic backgrounds), improving confidence in the test's performance in terms of accuracy and failure rate, and studying how the test results affect antibiotic prescribing decisions, are all reasonable and appropriate recommendations from our perspective. They will provide valuable data that will help to strengthen confidence in the clinical and cost-effectiveness of the test.

Overall, we are supportive of the draft guidance and the recommendations made and hope that the kit can be used more widely to help prevent hearing loss.”

Https://www.nice.org.uk/guidance/hte6/documents/consultation-comments-and-responses

I thought only babies with suspected infection will be tested with Genedrive kit but one NHS trust doing this for all babies admitted , which is new for me ..

‘’ The committee noted that one of the centres in the

PALOH study now routinely tests all babies on admission to the NICU. But it said that individual centres should decide which babies to test depending on local knowledge of what proportion of babies go on to receive aminoglycosides.’’

@Bighammer , Looks like they were cautious about the timelines this time , don’t want to over promise and under deliver …

Yes I did . , system and Nissan do yourself a favor .. take a break from this BB and this AIM game .. you both not designed for this :-) .. Have a good weekend , almost pub time .

Seems like Dr Death Aka Roger just sold out .. if I am not wrong he drafted the below message yesterday :-) .. nothing changed here .. we are in a better position than last week .. 2 world class Novel products and no real competition…sales will come

Https://www.nature.com/articles/s41397-024-00326-1

@system you should be less worried than couple of weeks ago ..:-) ..

Good points @Eureka @Gloria ..

https://pharmaphorum.com/news/nice-backs-use-post-stroke-genetic-testing