Leveraging longitudinal electronic healthcare data and pharmacogenomics to derive hormonal medication compatibility biomarkers (360G-Wellcome-318918_Z_24_Z)

Hormonal medications are accessible and effective with multiple uses, including contraception and menopausal hormone therapy, however many individuals experience side-effects, which may go unrecorded. Such side- effects can significantly impact patients’ quality of life and individuals may change medication formulation multiple times to identify the type with minimal side-effects, a potentially lengthy and distressing process. The biology underlying this differential response is largely unknown, presenting a challenge for clinicians prescribing. As a Wellcome Trust awardee, I will generate a deeper understanding of hormonal medication response aetiology and identify biomarkers of hormonal medication compatibility. I will: 1) Establish novel phenotypes describing hormonal medication compatibility in the case of contraceptive and menopausal hormone therapy usage, using longitudinal prescription data from electronic healthcare records. 2) Employ genetic association studies and statistical modelling to identify biomarkers of hormonal medication compatibility, assessing their predictive capabilities. 3) Elucidate biological pathways underlying hormonal drug compatibility using cutting-edge spatial transcriptomics towards identifying potential drug targets. This interdisciplinary research will have ramifications for researchers, clinicians and patients. For researchers, a deeper understanding of the biology underlying differential response to hormonal medication. For clinicians, assisting decision making towards personalised treatments. For patients, improved experience through efficient personalised prescription of hormonal medication.