Pharmacogenetic clinical decision support for psychiatric hospitalization: Design of the CYP-GUIDES randomized controlled trial.
Pharmacogenetic clinical decision support for psychiatric hospitalization: Design of the CYP-GUIDES randomized controlled trial.
复制标题
精神病住院的药物遗传学临床决策支持：CYP-GUIDES 随机对照试验的设计。
DOI：
10.1016/j.cct.2019.06.008
复制
发表时间：
2019
影响因子：
2.2
通讯作者：
Mehendru,Raveen
中科院分区：
文献类型：
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作者：
Ruaño,Gualberto;Holford,Theodore;Seip,RichardL;Goethe,JohnW;Mehendru,Raveen
CYP-GUIDES（用于决策支持的细胞色素精神药物基因分型研究）试验旨在为严重抑郁症住院患者的精神药物处方建立临床药物遗传学证据。依赖于肝细胞色素P450 2D 6酶（CYP 2D 6）代谢的药物的使用在精神病学中很普遍。证明一种方法的临床实用性，以确定和治疗不同的那些患者谁不能代谢这些药物是感兴趣的一般医疗保健。这项试验可能最终有助于开发CYP 2D 6基因分型和功能表型，用于药物治疗在重度抑郁症（MDD）管理中的应用，为对抗精神疾病增加了一个重要武器。本文介绍了一项随机对照试验（RCT）的设计，CYP 2D 6基因型指导与标准治疗精神病处方，建议解决这一证据gap.Over 1.4万住院精神卫生条件每年发生在美国（所有住院的3.4%），超过一半是MDD。根据最近的调查[1]，在美国，MDD住院治疗的疗程平均为6.8天，每天的费用为2000美元。每名病人的平均住院总费用为13，600元。
The CYP-GUIDES (Cytochrome Psychotropic Genotyping Under Investigation for Decision Support) trial aims to establish evidence for clinical pharmacogenetics in psychotropic prescription in severely depressed inpatients. The use of drugs dependent on metabolism by the hepatic Cytochrome P450 2D6 enzyme (CYP2D6) is widespread in psychiatry. Demonstrating clinical utility of a method to identify and treat differently those patients who cannot metabolize these drugs is of interest to general healthcare. This trial may ultimately help develop CYP2D6 genotyping and functional phenotyping for application of pharmacotherapy in the management of major depressive disorder (MDD), adding a crucial weapon in the battle against mental illness. This article describes the design of a Randomized Controlled Trial (RCT) of CYP2D6 genotype-guided versus standard care psychotropic prescription which proposes to address this evidence gap.Over 1.4 million hospitalizations for mental health conditions occur annually in the United States (3.4% of all hospitalizations), and more than half are for MDD. Hospitalization for MDD results in a course of treatment in the United States that averages 6.8 days at a cost of $2000 per day according to recent surveys [1]. The mean total cost per patient of such hospitalization is $13,600.