The utility of pharmacogenetic testing to support the treatment of bipolar disorder
The utility of pharmacogenetic testing to support the treatment of bipolar disorder
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DOI：
10.2147/pgpm.s160967
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发表时间：
2018-01-01
影响因子：
1.9
通讯作者：
Callegari, Camilla
中科院分区：
文献类型：
--
作者：
Ielmini, Marta;Poloni, Nicola;Callegari, Camilla
背景：双相情感障碍（BD）是导致残疾、医疗费用和自杀风险的常见原因。药物遗传学测试（PGTs）可以帮助临床医生识别那些易发生不良事件（AE）的患者，提高对遗传变异和药物反应之间相关性的理解。材料和方法：该研究评估了30例BD I型或II型患者（根据精神疾病诊断和统计手册，第5版），接受PGT Neurofarmagen（R）（AB-BIOTICS SA，巴塞罗那，西班牙），2016年3月至2017年3月。本研究的主要目的是确定精神科医生处方的治疗是否与T0时PGT建议的治疗一致（对应于检查报告通信）。作为次要目的，我们想评估临床医生是否改变了治疗（在不一致的情况下）在T1（3个月随访访视）根据PGT.Results的结果：在T0，只有4例患者（13%）有一个最佳的治疗符合PGT的建议。在3个月随访时，13例患者（40%）接受了与测试一致的治疗变化，与未发生与测试一致变化的患者相比，临床总体印象项目严重程度（CGI-S）评分随时间推移有显著的统计学改善。关于AE，在基线时，根据试验接受治疗调整的10例患者中有9例（90%）出现AE，3个月后观察到组内显著减少（p = 0.031）。尽管样本量很小，该研究显示了关于PGT的有用性的有希望的数据，以支持临床医生在常规治疗中获得更有效和更耐受的治疗BD的方法。
Background: Bipolar disorder (BD) is a frequent cause of disability, health care costs, and risk of suicide. Pharmacogenetic tests (PGTs) could help clinicians to identify those patients predisposed to the occurrence of adverse events (AEs) improving the understanding of the correlation between genetic variants and drug response.Materials and methods: The study evaluated 30 patients affected by BD type I or II (according to Diagnostic and Statistical Manual of Mental Disorders, version 5) who underwent the PGT Neurofarmagen (R) (AB-BIOTICS SA, Barcelona, Spain) between March 2016 and March 2017. The primary aim of this study was to identify if the treatment prescribed by the psychiatrists was consistent with the treatment suggested by the PGT at T0 (corresponding to the test report communication). As a secondary aim, we wanted to assess if clinicians had changed the treatment (in case of discordance) at T1 (3-month follow-up visit) according to the results of the PGT.Results: At T0, only 4 patients (13%) had an optimal therapy in line with the PGT suggestions. At 3-month follow-up, 13 patients (40%) had received a change of therapy consistent to the test, showing a significant statistical improvement in the Clinical Global Impression item Severity (CGI-S) score over time compared to those not having changes consistent with the test. Regarding AEs, at baseline 9 out of 10 (90%) of the patients who received a therapy modification according to the test presented AEs, and a significant within-group reduction was observed after 3 months (p = 0.031).Conclusion: Despite the small sample size, the study shows promising data about the usefulness of PGT to support clinicians in reaching a more effective and tolerated treatment in the routine approach of BD.