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| http://dx.doi.org/10.1111/cts.12456 | DOI Listing |
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Implementing a pragmatic clinical trial to tailor opioids for chronic pain on behalf of the IGNITE ADOPT PGx investigators.
Clin Transl Sci
August 2024
Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Chronic pain is a prevalent condition with enormous economic burden. Opioids such as tramadol, codeine, and hydrocodone are commonly used to treat chronic pain; these drugs are activated to more potent opioid receptor agonists by the hepatic CYP2D6 enzyme. Results from clinical studies and mechanistic understandings suggest that CYP2D6-guided therapy will improve pain control and reduce adverse drug events.
View Article and Find Full Text PDFRationale and design for a pragmatic randomized trial to assess gene-based prescribing for SSRIs in the treatment of depression.
Clin Transl Sci
June 2024
Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Article Synopsis
- SSRIs' metabolism is significantly affected by the pharmacogenes CYP2D6 and CYP2C19, which influences how effective these medications might be for treating depression in patients.
- A clinical trial is being conducted to assess whether using genetic testing to guide the selection and dosing of antidepressants can provide better control of depression symptoms in individuals aged 8 and older.
- The trial includes two groups: one gets pharmacogenetic testing and support immediately, while the other group is tested after 6 months, with the main outcome measured being changes in depression scores after three months.
Clinical and genetic determinants of the fatty liver-coagulation balance interplay in individuals with metabolic dysfunction.
JHEP Rep
December 2022
Università Degli Studi di Milano, Department of Pathophysiology and Transplantation, Milan, Italy.
Background & Aims: The aim of this study was to examine the determinants of the interplay between liver damage and the coagulation balance in individuals at risk of non-alcoholic fatty liver disease (NAFLD).
Methods: We considered 581 healthy participants with ≥3 metabolic alterations undergoing clinical and genomic evaluation, measurement of liver stiffness (LSM) and controlled attenuation parameter (CAP) by Fibroscan, Pro-C3, coagulation balance (von Willebrand factor [vWF], factor VIII/protein C ratio [F8/PC] as the main outcome, D-dimer as marker of coagulation/fibrinolysis activation).
Results: Liver fibrosis indices (both Fibrosis-4 [FIB-4] and liver stiffness measurement [LSM]), but not liver fat (CAP), were independently associated with higher F8/PC ratio ( <0.
Implementing a pragmatic clinical trial to tailor opioids for acute pain on behalf of the IGNITE ADOPT PGx investigators.
Clin Transl Sci
October 2022
Department of Pharmacotherapy and Translational Research and Center for Pharmacogenomics and Precision Medicine, College of Pharmacy, University of Florida, Gainesville, Florida, USA.
Opioid prescribing for postoperative pain management is challenging because of inter-patient variability in opioid response and concern about opioid addiction. Tramadol, hydrocodone, and codeine depend on the cytochrome P450 2D6 (CYP2D6) enzyme for formation of highly potent metabolites. Individuals with reduced or absent CYP2D6 activity (i.
View Article and Find Full Text PDFEffect of Pharmacogenomic Testing for Drug-Gene Interactions on Medication Selection and Remission of Symptoms in Major Depressive Disorder: The PRIME Care Randomized Clinical Trial.
JAMA
July 2022
VA Puget Sound Health Care System, Tacoma, Washington.
Article Synopsis
- The study investigates whether pharmacogenomic testing can improve the selection of antidepressants for patients with major depressive disorder (MDD) and lead to better treatment outcomes compared to standard care.
- Conducted at 22 Veterans Affairs medical centers, the trial involved 1,944 patients and 676 clinicians, assessing the effectiveness of treatment guided by pharmacogenomic results over 24 weeks.
- Results showed a significant portion of the pharmacogenomic-guided group received prescriptions with fewer drug-gene interactions, suggesting potential advantages in using such testing for choosing antidepressants in MDD treatment.
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