By Clinical Research News Staff 

June 18, 2025 | The UK National Health Service’s PROGRESS trial has achieved remarkable clinical success, with one in four patients having their prescriptions adjusted based on genetic test results, leading to safer and more effective treatments. 

The PROGRESS trial’s interim results reveal that 95% of the 500 patients tested carried genetic variants that directly influence how they metabolize common medications. More significantly from a clinical perspective, just over 25% of participants had their prescriptions modified to achieve better therapeutic outcomes, with healthcare providers following the genetic guidance in the "vast majority" of cases. 

Dr. John McDermott, who co-leads the NHS-England Network of Excellence for Pharmacogenomics & Medicines Optimization, emphasizes the immediate clinical relevance: "We know a large proportion of medical treatments that are issued in routine clinical care are ineffective or don't work at all... You see that borne out in the proportion of people who don't respond to the first-line antidepressants, or… go on to have secondary strokes." 

Real-World Clinical Applications 

The clinical program addresses critical therapeutic areas where genetic variation significantly impacts patient outcomes. For stroke patients receiving clopidogrel, genetic testing identifies the 25-30% of UK patients who have reduced response to this antiplatelet medication due to CYP2C19 gene variants. This testing is now recommended by the National Institute for Health and Care Excellence for all stroke and transient ischemic attack (TIA) patients. 

The NHS has already integrated pharmacogenomic testing into routine cancer care, with approximately 40,000 patients annually receiving DPYD gene testing before starting fluoropyrimidine-based chemotherapy. This screening prevents severe, potentially life-threatening adverse reactions by identifying patients who metabolize these cancer drugs differently. 

Making Genetic Data Actionable 

A key clinical innovation involves seamlessly integrating pharmacogenomic results into existing healthcare workflows. The PROGRESS trial developed a system that delivers genetic testing results directly through electronic health records, creating pop-up alerts when physicians prescribe medications affected by a patient's genetic profile. 

This approach mirrors familiar clinical decision support tools, such as alerts for kidney function when prescribing certain antibiotics. "Our attitude is that pharmacogenomic data should be treated like any other biomarker," McDermott explains, making genetic information as accessible and actionable as routine laboratory results. 

The seven-day median turnaround time for results has proven clinically acceptable for most situations, with patients generally comfortable waiting for genetic guidance before starting new medications. When immediate treatment is necessary, physicians can prescribe medications and adjust them later based on genetic results. 

Patient Safety and Quality of Life Improvements 

The clinical benefits extend beyond simply avoiding ineffective medications. By identifying patients at risk for adverse drug reactions early, the program prevents hospitalizations, reduces the need for multiple medication trials, and helps patients achieve therapeutic goals more quickly. 

McDermott notes that approximately one in eight participants receive "red flag" recommendations requiring immediate prescription changes based on their genetic data. These interventions can prevent serious complications, such as secondary strokes in patients taking inappropriate antiplatelet medications, or severe chemotherapy toxicity in cancer patients with specific genetic variants. 

Multi-Specialty Clinical Implementation 

The PROGRESS trial focuses on medications used across multiple medical specialties—statins for cardiovascular disease, opioids for pain management, antidepressants for psychiatric conditions, and proton pump inhibitors for gastrointestinal disorders. This broad approach demonstrates how pharmacogenomic testing can benefit patients throughout the healthcare system rather than being limited to specialized practice areas. 

The clinical program operates across 20 sites throughout England, including both primary care practices and hospitals, ensuring that genetic guidance reaches patients regardless of where they receive care. This comprehensive implementation addresses health equity concerns by making precision medicine available system-wide rather than only at specialized academic centers. 

For Deborah Borfitz’s full story, please see Diagnostics World News.