Will Plavix black box prompt gene tests?

Will a new FDA warning on Plavix help the personalized-medicine cause, or will it just confuse people? That's the question the Wall Street Journal Health Blog asks today. A new "black box" warning has been added to Bristol-Myers Squibb/Sanofi-Aventis' anti-clotting medicine Plavix, which is poorly metabolized by up to 14 percent of patients who use it. Those patients, who have a particular genetic variant, could do better on another anticoagulant or on higher Plavix doses, the warning states.

Perhaps the FDA envisions that doctors will now be more likely to follow its recommendation to test patients for that variant before prescribing Plavix. But do enough doctors have access to the tests? Will they have time to wait for the results? Before such an approach grows common, cardiology associations will have to develop treatment protocols, experts tell the WSJ. Meanwhile, says one Harvard Medical School associate prof, "I expect mass confusion in response to this FDA warning."

This could be an opportunity for upstart Plavix competitor Effient, from Eli Lilly and Daiichi Sankyo, but that drug carries an increased bleeding risk. Or it could be an opportunity for Medco Health Solutions, which last week said it was expanding its personalized-medicine programming--and planned to extend that program to Plavix at some point. Maybe that point has arrived.

- read the FDA release
- see the WSJ Health Blog story
- get more from the WSJ