New Study Shows that the Drug-Drug Interactions and Lifestyle Factors Provided by Castle Biosciences’ IDgenetix® Test Significantly Improve Medication Recommendations Over Drug-Gene Interactions Alone for Patients 65 and Older

Study data show that one-third of the IDgenetix-guided medication recommendations were due to drug-drug interactions and lifestyle factors, demonstrating the value of this additional information in guiding selection of neuropsychiatric medications for older adults in cohort of patients 65 and older, with majority being on five or more medications at the time of testing

Castle Biosciences, Inc. (Nasdaq: CSTL), a company improving health through innovative tests that guide patient care, today announced new data highlighting the value of its IDgenetix pharmacogenomic (PGx) test in guiding medication recommendations for patients with mental health conditions who are 65 and older. The data will be shared via a poster presentation at the 2024 American Association for Geriatric Psychiatry (AAGP) Annual Meeting, taking place March 15-18 in Atlanta.

“Pharmacogenomics has been increasingly used to identify genetic variations associated with drug response; however, its potential in older adults who are more likely to be on multiple medications and experience adverse drug events has not been fully explored,” said Robert Cook, Ph.D., senior vice president of research and development at Castle Biosciences. “This study found that, despite all patients carrying potentially clinically significant genetic variants, one-third of medication recommendations were due to drug-drug interactions and lifestyle factors provided on the IDgenetix report. This is especially important as real-world evidence shows that polypharmacy, taking five or more prescription medications, occurs in more than half of elderly patients.¹”

Poster Title: Pharmacogenomic Characteristics and IDgenetix-Guided Medication Management for Older Adults with Depression and Anxiety

Presenting Author: Raymond A. Lorenz, Pharm.D., BCPP, Castle Biosciences, Inc.

Date and Time: Saturday, March 16, from 5-7 p.m. Eastern Time

Location: Grand Ballroom, Hanover Hall and Embassy Hall Exhibition Level at the Hyatt Regency Atlanta

IDgenetix is an advanced 3-in-1 PGx test that incorporates genetic information, drug-drug interactions and lifestyle factors to produce a report that can help clinicians select optimal medications for their patients with depression, anxiety and other neuropsychiatric illnesses. The study analyzed gender, age and diagnosis, including attention-deficit/hyperactivity disorder, anxiety, bipolar disorder, depression, obsessive-compulsive personality disorder, pain, post-traumatic stress disorder and schizophrenia, from a sample of IDgenetix reports for patients 65 and older (n=737). The most common psychiatric diagnoses for which IDgenetix was ordered included depression and anxiety. Additionally, 58% of the patients in the study were on five or more medications, with an average of seven, at the time of testing.

All patients in the study had genetic polymorphisms that could impact medication selection in at least three of the 15 genes on the IDgenetix report. While drug-gene interactions accounted for 66% of all medication recommendations, drug-drug interactions and lifestyle factors accounted for 34% (27% and 7%, respectively), demonstrating the value of the IDgenetix 3-in-1 test in providing tailored guidance to help clinicians select the optimal medications for their patients.

About IDgenetix

IDgenetix is a pharmacogenomic (PGx) test for depression, anxiety and other mental health conditions designed to analyze a patient’s genetic make-up to guide timely and evidence-based decisions on the optimal drug for each patient. IDgenetix is designed to provide important genetic information to clinicians to help guide personalized treatment plans for their patients, with the potential to help patients achieve a faster therapeutic response and improve their chances of remission by identifying appropriate medications more efficiently than the standard of care trial-and-error approach. IDgenetix provides drug-drug and drug-gene interactions and is supported by a published, peer-reviewed randomized controlled trial that demonstrated clinical utility over the standard of care when physicians used IDgenetix prior to prescribing a medication. IDgenetix is currently reimbursed by Medicare for the following eight mental health conditions: major depressive disorder, schizophrenia, bipolar disorder, anxiety disorders, panic disorder, obsessive-compulsive personality disorder, post-traumatic stress disorder and attention deficit hyperactivity disorder.

About Castle Biosciences

Castle Biosciences (Nasdaq: CSTL) is a leading diagnostics company improving health through innovative tests that guide patient care. The Company aims to transform disease management by keeping people first: patients, clinicians, employees and investors.

Castle’s current portfolio consists of tests for skin cancers, Barrett’s esophagus, mental health conditions and uveal melanoma. Additionally, the Company has active research and development programs for tests in other diseases with high clinical need, including its test in development to help guide systemic therapy selection for patients with moderate-to-severe atopic dermatitis, psoriasis and related conditions. To learn more, please visit www.CastleBiosciences.com and connect with us on LinkedIn, Facebook, X and Instagram.

DecisionDx-Melanoma, DecisionDx-CMSeq, DecisionDx-SCC, MyPath Melanoma, DiffDx-Melanoma, TissueCypher, IDgenetix, DecisionDx-UM, DecisionDx-PRAME and DecisionDx-UMSeq are trademarks of Castle Biosciences, Inc.

Forward-Looking Statements

This press release contains forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended, which are subject to the “safe harbor” created by those sections. These forward-looking statements include, but are not limited to, statements concerning: the potential of pharmacogenomics to affect medication recommendations for older adults; and the value of the IDgenetix 3-in-1 test in providing tailored guidance to help clinicians select the optimal medications for their patients. The words “believe,” “can” and similar expressions are intended to identify forward-looking statements, although not all forward-looking statements contain these identifying words. We may not actually achieve the plans, intentions or expectations disclosed in our forward-looking statements, and you should not place undue reliance on our forward-looking statements. Actual results or events could differ materially from the plans, intentions and expectations disclosed in the forward-looking statements that we make. These forward-looking statements involve risks and uncertainties that could cause our actual results to differ materially from those in the forward-looking statements, including, without limitation: subsequent study or trial results and findings may contradict earlier study or trial results and findings or may not support the results obtained in these studies, including with respect to the discussion of our tests in this press release; actual application of our tests may not provide the aforementioned benefits to patients; and the risks set forth under the heading “Risk Factors” in our Annual Report on Form 10-K for the year ended December 31, 2023, and in our other filings with the SEC. The forward-looking statements are applicable only as of the date on which they are made, and we do not assume any obligation to update any forward-looking statements, except as may be required by law.

1. Wang X, Liu K, Shirai K, et al. Prevalence and trends of polypharmacy in U.S. adults, 1999–2018. Glob Health Res Policy. 2023;8(25). https://doi.org/10.1186/s41256-023-00311-4

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