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" ... If Kathiresan and Khera are correct, and if their hypothesis extends beyond CAD, it means we should think carefully about reflexively assuming diligent data collection will permit us to subdivide complex disease – like multiple sclerosis and Alzheimer’s – into biologically and therapeutically distinct subcategories. At the same time, their argument suggests we should aggressively pursue robust molecular clues that have been identified, as pharmacologically targeting the products of genes with seemingly small effect could still have major impact, as the statin experience demonstrates. Individual rare variants with clear phenotypic effect might be particularly helpful in pointing out high value targets. Furthermore, based on Kathiresan and Khera’s hypothesis, drugs developed based on these targets might be expected to impact most patients, not just a select few. In short, while comprehensive genetic and phenotypic evaluation might be required to identify patients with high impact rare variants, once identified, these variants can lead to the development of a new medicine that has generalized utility. In other words: precision research, blockbuster development. ... "
" ... These products possess the same possible adverse reactions as their prescription counterparts, known pharmacologically as phosphodiesterase-5 (PDE5) inhibitors. Their action on the penis is due to enhancement of nitric oxide-mediated dilation of blood vessels required to sustain an erection. In fact, sildenafil was originally investigated as a hypertension drug. ... "