Pharmacogenetic testing for the guidance of psychiatric treatment: a multicenter retrospective analysis

被引:32
作者
Espadaler, Jordi [1 ]
Tuson, Miquel [1 ]
Miguel Lopez-Ibor, Jose [2 ]
Lopez-Ibor, Franciso [3 ]
Ines Lopez-Ibor, Maria [4 ,5 ]
机构
[1] AB Biot SA, Innovat Dept, Barcelona, Spain
[2] Ctr Dr Lopez Ibor SA, Madrid, Spain
[3] Quibor SL, Madrid, Spain
[4] Univ Complutense Madrid, Dept Psychiat, Coll Med, Madrid, Spain
[5] Inst Neurol Invest Lopez Ibor, Madrid, Spain
关键词
anxiety; bipolar disorder; depression; genomics; personalized medicine; pharmacogenetics; psychiatric treatment; psychotic disorder; ANTIDEPRESSANT TREATMENT; OUTCOMES; DRUGS; TERM;
D O I
10.1017/S1092852915000711
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Objective. We investigated the association between clinical outcome and the recommendations of a pharmacogenetic test (Neuropharmagen) in patients with a variety of psychiatric conditions whose previous treatment regimen had failed. Methods. This retrospective, naturalistic, multicenter study included adult psychiatric patients (depression, psychosis, anxiety, bipolar, etc.) who had been seen at 3 private clinics. All patients had received pharmacogenetic testing (Neuropharmagen) and were classified depending on whether or not their post-test treatment regimen followed the test recommendations. Clinical severity was assessed with the Clinical Global Impression of Severity (CGI-S) at baseline (pre-test) and 3-month follow-up, and adverse events were recorded. Results. 182 patients were available for analysis. After multivariate adjustment, patients whose treatment followed the test recommendations had odds of improvement about 4 times greater than patients whose treatment did not follow the recommendations (adjusted OR=3.86, 95%CI 1.36-10.95; p=0.011). Importantly, psychiatric diagnosis did not significantly affect the odds of improvement. Also, in the subpopulation with baseline CGI-S score >3 (N=170), the rate of stabilization at follow-up (defined as CGI-S <= 3) was significantly higher in patients whose treatment followed the pharmacogenetic recommendations (p=0.033). There was no apparent difference in the incidence of adverse events (6 patients in each group). Conclusions. Non-drug naive patients whose treatment followed the recommendations of pharmacogenetic testing were more likely to improve their condition than patients whose treatment did not. These results are consistent with previous clinical research on depressed patients, and this study also suggests that this benefit can be extended to psychiatric conditions other than depression.
引用
收藏
页码:315 / 324
页数:10
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