Annette Gross

Ethnopharmacology Director
Pharmaceuticals
Joined GSK in 1999

Annette Gross is recognised as a leading expert in Ethnopharmacology and has been invited on many occasions to present at International Scientific Conferences and to Government Authorities in this very important area of health research.

By sharing her knowledge and experience in this way she is helping to develop understanding of this cutting edge science that benefits patients.

What is ethnopharmacology?

It’s looking at differences in drug response across ethnic groups. People from different ethnic groups have the potential for different drug responses and therefore a drug or drug dose may need to be tailored to a patient’s ethnicity.

What does you job entail? 

GSK medicines are used in patients around the world and increasingly clinical trials include patients of different ethnic groups  from many countries around the world.

The Ethnopharmacology Group looks at factors that can contribute to inter-ethnic differences in drug response and whether they might apply to our medicines in development. My team also contributes to decisions concerning drug development strategies, the design and analysis of studies in specific ethnic groups and the evaluation of the results of global studies to understand whether ethnicity is an important contributor to variation in drug response.

Why is it so important to understand difference in the way ethnic groups respond to medicines?

Medicines should be effective and safe in all patients, irrespective of ethnicity. If a particular ethnic group has a higher concentrations of a medicine after being given the same dose, they may have an amplified response to the medicine and possibly side effects. Alternatively the concentrations of the medicine may be lower and the desired therapeutic benefit may not be achieved.

Is it known why these ethnic differences exist?

A number of factors contribute to inter-ethnic  differences in drug response. There is very good research providing a greater understanding of the contribution of genetics to variation in drug response between individuals and also between ethnic groups. We’re seeing that some of the genes which might be important for drug response can differ in frequency in populations of Asian and European ancestry.  

Genetics is not the only factor to consider. For example ethnic groups may differ in body weight, exposure to environmental factors such as diet, medical practise and also cultural practises.

How are these challenges being overcome?

There are some examples where different doses are recommended for patients based on their ethnic background.

For example in Asian patients the recommended starting dose of rosuvastatin, a drug used to lower cholesterol levels, is half the starting dose recommended in Western patients. Research has also demonstrated that the clinical efficacy of the anticoagulant warfarin is achieved in patients of Asian ancestry at lower doses than in patients of European ancestry.

What implications are there for multi-cultural Australia?

The main focus of ethnopharmacology at GSK is to support drug development programs in Asia. In some Asian countries the regulatory authorities consider the relevance to their local patients of clinical trial data obtained principally in patients of European ancestry in Europe, Australia or North America.

But, of course, if there is a difference in Asian patients it would be expected to apply to all Asian people whether they are residents in Asia or residents in Australia. So our work is definitely of relevance to multi-ethnic populations including Australia.

What motivates you?

It’s our goal to ensure GSK medicines will be used optimally in all patients and all populations. It’s inspiring to be an Australian team working for a global enterprise and contributing to the development of new medicines, which can make an important difference to patients’ lives. That is a real motivator.