Pharmacogenetic determinants of opioid addiction maintenance treatment with buprenorphine in a Caribbean Hispanic Population

摘要： 阿片类药物成瘾维持治疗的药物遗传学决定因素 丁丙诺啡在加勒比海西班牙裔人群中的应用 摘要：阿片类药物使用障碍的流行导致了超过60，000例过量死亡， 2017年美国。目前的指南建议结合药理学 维持治疗（通常使用美沙酮或丁丙诺啡）和心理社会 治疗最近，丁丙诺啡用于阿片类药物使用障碍的情况有所增加 戏剧性地，部分原因是与美沙酮相比，管理障碍较少。 尽管如此，患者对丁丙诺啡反应的变异性可能导致一些患者失败 治疗除了性别和伴随用药等临床特征外， 影响患者对丁丙诺啡反应的变异性，遗传变异性可能是 阿片类药物成瘾的药物治疗反应的复杂表型。 尽管特定的药物基因（OPRM 1、OPRD 1、UGT 2B7和CYP 3A4）已被 确定可能有助于丁丙诺啡的反应，但缺乏数据， 西班牙裔人口。这一可解决的疏忽令人非常关切，因为它往往会 加剧了现有的医疗保健差距，已经存在的影响西班牙裔， 这个试验计划的目的，是让市民更了解 影响个体患者临床应答的药物遗传学变量 丁丙诺啡用于治疗阿片类药物使用障碍。通过测量丁丙诺啡血浆 水平和治疗反应的临床指标，我们将进行候选基因 关联研究，以更好地了解相关药物基因如何影响 加勒比海西班牙裔人口正在接受阿片类药物使用障碍治疗。的长期目标 这项研究是为了开发面向加勒比海西班牙裔的DNA指导治疗方法， 阿片类药物使用障碍

Abstract: Pharmacogenetic determinants of opioid addiction maintenance treatment with buprenorphine in a Caribbean Hispanic Population Abstract: The opioid use disorder epidemic resulted in over 60,000 overdose deaths in the United States in 2017. Currently guidelines recommend a combination of pharmacologic maintenance treatment (usually with methadone or buprenorphine) and psychosocial treatment. Recently, the use of buprenorphine for opioid use disorder has increased dramatically, partly due to fewer barriers to administration when compared to methadone. Nonetheless, variability in patient response to buprenorphine may lead some patients to fail treatment. In addition to clinical characteristics such as sex and concurrent medications that affect patient variability in response to buprenorphine, genetic variability may be a factor in the complex phenotype of therapeutic response to pharmacotherapy for opioid addiction. Although specific pharmacogenes (OPRM1, OPRD1, UGT2B7, and CYP3A4) have been identified that may contribute to the response of buprenorphine, there is a paucity of data in Hispanic populations. This addressable oversight is of great concern, since it will tend to exacerbate existing healthcare disparities that already exist affecting Hispanics with regards to the treatment of addiction.This pilot project aims to better understand the pharmacogenetic variables which affect the individual patient’s clinical response to buprenorphine for the treatment of opioid use disorder. By measuring buprenorphine plasma levels and clinical indicators of treatment response, we will perform a candidate gene association study to better understand how relevant pharmacogenes affect outcomes in a Caribbean Hispanic population being treated for opioid use disorder. The long-term goal of this research is to develop Caribbean Hispanic-oriented DNA-guided approach to treatment for opioid use disorder.