Epigenetic Therapies

How drugs edit methylation, histones, and cofactors to treat disease.

“The goal is not to methylate everything. The goal is to regulate the right genes, in the right tissues, at the right time, at the right intensity.”

DNMT

Azacitidine / Decitabine

Mechanism

Cytidine analogs trap DNMT1 → passive demethylation across divisions.

Clinical use

MDS, AML (low-intensity), CMML.

Caveats

Cytopenias; effect takes 3-6 cycles; oral form available (Inqovi).

These drugs don't change your DNA — they change how your DNA is read.