Pharmacokinetic Markers of Clinical Outcomes in Severe Mental Illness: A Systematic Review

被引:2
作者
Paribello, Pasquale [1 ,2 ]
Manchia, Mirko [1 ,2 ,3 ]
Pinna, Federica [1 ,2 ]
Isayeva, Ulker [1 ,2 ]
Squassina, Alessio [4 ]
Pisanu, Claudia [4 ]
Balderi, Lorenzo [1 ,2 ]
Contu, Martina [1 ,5 ]
Pinna, Marco [1 ,5 ]
Carpiniello, Bernardo [1 ,2 ]
机构
[1] Univ Cagliari, Dept Med Sci & Publ Hlth, Sect Psychiat, I-09124 Cagliari, Italy
[2] Univ Hosp Agcy Cagliari, Unit Clin Psychiat, I-09124 Cagliari, Italy
[3] Dalhousie Univ, Dept Pharmacol, Halifax, NS B3H 4R2, Canada
[4] Univ Cagliari, Dept Biomed Sci, Sect Neurosci & Clin Pharmacol, I-09042 Cagliari, Italy
[5] Lucio Bini Mood Disorders Ctr, I-09128 Cagliari, Italy
关键词
pharmacogenomics; severe mental illness; systematic review; precision psychiatry; prediction; MAJOR DEPRESSIVE DISORDER; CYP2D6 P34S POLYMORPHISM; MDR1 GENE POLYMORPHISMS; THERAPEUTIC RESPONSE; ASSOCIATION; ABCB1; SCHIZOPHRENIA; RISPERIDONE; CYTOCHROME-P450; METABOLISM;
D O I
10.3390/ijms24054776
中图分类号
Q5 [生物化学]; Q7 [分子生物学];
学科分类号
071010 ; 081704 ;
摘要
The term severe mental illness (SMI) encompasses those psychiatric disorders exerting the highest clinical burden and socio-economic impact on the affected individuals and their communities. Pharmacogenomic (PGx) approaches hold great promise in personalizing treatment selection and clinical outcomes, possibly reducing the burden of SMI. Here, we sought to review the literature in the field, focusing on PGx testing and particularly on pharmacokinetic markers. We performed a systematic review on PUBMED/Medline, Web of Science, and Scopus. The last search was performed on the 17 September 2022, and further augmented with a comprehensive pearl-growing strategy. In total, 1979 records were screened, and after duplicate removal, 587 unique records were screened by at least 2 independent reviewers. Ultimately, forty-two articles were included in the qualitative analysis, eleven randomized controlled trials and thirty-one nonrandomized studies. The observed lack of standardization in PGx tests, population selection, and tested outcomes limit the overall interpretation of the available evidence. A growing body of evidence suggests that PGx testing might be cost-effective in specific settings and may modestly improve clinical outcomes. More efforts need to be directed toward improving PGx standardization, knowledge for all stakeholders, and clinical practice guidelines for screening recommendations.
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页数:20
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