Prometheus Laboratories Inc., a specialty pharmaceutical and diagnostics company that is part of Nestlé Health Science, and the Medco Research Institute, a wholly-owned subsidiary of Medco Health Solutions, Inc. announced that they have entered into a collaboration to evaluate the use of Prometheus’ Thiopurine Metabolite (PTM) testing for optimizing dosing of 6 mercaptopurine (6MP) or azathioprine (Aza) in patients with Inflammatory Bowel Disease (IBD). Optimization of dosing could lead to improved drug response and delay progression to more aggressive therapy.

Thiopurine immunomodulators, such as 6MP or its pro-drug Aza, are effective medical treatments for IBD when appropriately dosed. However, studies have shown that patients are frequently under dosed which can decrease the efficacy of these drugs. Through PTM testing, doctors may be able to select those patients who would benefit from dose adjustments and those that may have a risk of toxicity. Patients who are not responding due to lack of compliance could also be identified. This collaboration will evaluate whether PTM testing, used early after the decision is made to prescribe thiopurines, increases the time that patients remain on these drugs and thus reduces the rate at which patients transition to expensive alternative treatments.

“We believe that this collaboration provides an opportunity to show how our Prometheus Thiopurine Metabolite test can be used to optimize immunomodulator therapy for IBD patients,” said Joseph Limber, Prometheus’s chief executive officer. “The results of this pilot project could help provide evidence supporting the clinical value and cost effectiveness of the routine use of this testing in patients taking thiopurine drugs.”

“Programmes of this nature have the potential to show that understanding a patient’s molecular make-up with the help of a diagnostic test can improve a drug’s efficacy and safety,” said Felix Frueh, PhD, president, Medco Research Institute. “Working with Prometheus, Medco can help its clients better understand the value of these tests for IBD patients, and may assist physicians to make a personalized treatment decision for patients with this serious disease.”

Through this collaboration, the companies will conduct the RECEIPT project (Research to Evaluate the Cost Effectiveness of Interventions with Prescriptions of Thiopurines), a pilot programme to evaluate the benefit of PTM testing in IBD patients who have recently received a prescription for either 6MP or Aza. In addition, the collaboration will evaluate the cost effectiveness of PTM testing.

The Medco Research Institute will work with Medco clients to recruit patients to take part in the pilot program.  It is anticipated that up to 500 Medco members who are using 6MP or Aza will have the PTM testing performed, and the downstream medical and pharmacy data from these patients will be compared to a similar number of Medco members who did not received PTM testing as part of their care, in order to determine the impact of PTM testing.

Personalized medicine is an area of healthcare that is becoming more widely used to focus on how a person’s molecular makeup can affect their ability to respond to medications, allowing physicians better precision in selection or dosing of a drug thereby improving drug safety and efficacy.

IBD, including Crohn’s disease and ulcerative colitis, is a chronic inflammatory condition of the intestinal tract. Symptoms of the disease may include diarrhoea, abdominal pain, fever and rectal bleeding. Patients may require long-term medical care, including hospitalizations, surgeries and therapeutics. The condition can be difficult to manage clinically and consumes a substantial amount of healthcare resources in terms of physician time, procedures and medications.

Prometheus Laboratories Inc. is committed to improving lives through the development and commercialization of novel pharmaceutical and diagnostic products that enable physicians to provide greater individualized patient care.

Nestlé Health Science, a fully-owned subsidiary of Nestlé S.A., is operational since January 1, 2011 and has worldwide headquarters in Lutry, Switzerland. Nestlé Health Science offers nutritional solutions for people with specific dietary needs related to illnesses, disease states or the special challenges of different life stages.

Medco Research Institute is an evidence-based research organization focused solely on novel research, analytics and new discoveries that close the gap between scientific discovery and medical practice for improved patient outcomes and lower overall healthcare costs.

Medco Health Solutions, Inc. is pioneering the world's most advanced pharmacy and its clinical research and innovations are part of Medco making medicine smarter for approximately 65 million members.