Subanalysis of the CYP-GUIDES Trial: CYP2D6 Functional Stratification and Operational Timeline Selection.
Subanalysis of the CYP-GUIDES Trial: CYP2D6 Functional Stratification and Operational Timeline Selection.
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CYP-GUIDES 试验的子分析：CYP2D6 功能分层和操作时间线选择。
DOI：
10.1016/j.psychres.2020.113571
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发表时间：
2021
影响因子：
11.3
通讯作者：
Goethe,JohnW
中科院分区：
文献类型：
--
作者：
Ruaño,Gualberto;Tortora,Joseph;Robinson,Saskia;Baker,Seth;Holford,Theodore;Winokur,Andrew;Goethe,JohnW
CYP-GUIDES（CytochromePsychotropicGenotypingUnderInvestigationforDecisionSupport）是一项随机对照试验，比较了根据患者CYP 2D 6基因型和功能状态治疗的住院抑郁症患者与标准精神药物治疗的2种结局。主要终点为住院时间（LOS），次要终点为出院后30天的再入院率（RAR）。该试验的方法、总结果和数据库已经公布。本文中我们提出了一个亚组分析，分离出3个混杂因素来评估CYP 2D 6治疗指导对LOS的影响：一份电子病历、至少3天的LOS和患者的CYP 2D 6功能分层。与S组相比，G组的亚功能患者的LOS缩短了2天。药物管理的亚功能患者在组Sevidenced较高的百分比CYP 2D 6底物精神药物被规定，以及更多的处方比在functionalpatients.We得出结论，有一个效果的药物遗传学的临床决策支持，减少LOS患者的CYP 2D 6亚功能状态和减少处方的CYP 2D 6底物依赖性药物。
CYP-GUIDES(CytochromePsychotropicGenotypingUnderInvestigation forDecisionSupport)was a Randomized Controlled Trial comparing 2 outcomes in hospitalized patients with major depressive disorder treated according to the patient'sCYP2D6genotype and functional status versus standard psychotropic therapy. The primary outcome was hospitalLength of Stay(LOS) and the secondary wasRe-Admission Rate(RAR) 30 days after discharge. Methodology, total results and database of the trial have been published. Here we present a subanalysis that isolated 3 confounders to assess the impact of CYP2D6 therapeutic guidance on LOS: a single Electronic Medical Record, a minimum 3-day LOS, and CYP2D6 functional stratification of patients.CYP2D6 functional stratification enabled subgrouping patients and comparing outcomes according to CYP2D6 functionality withinGroup GandGroup S. Subfunctional patients evidenced a 2-day shorter LOS inGroup Gcompared toGroup S. Drug administration for subfunctional patients inGroup Sevidenced a higher percentage of CYP2D6 substrate psychotropics being prescribed as well as a greater number of prescriptions than in functional patients.We conclude that there was an effect of pharmacogenetic clinical decision support that reduced LOS in patients with CYP2D6 subfunctional status and reduced prescribing of CYP2D6 substrate dependent drugs.