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

摘要： 阿片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拉美裔人群中的应用 摘要：阿片类药物使用障碍的流行导致超过6万人过量死亡。 2017年在美国。目前，指南建议联合应用药理作用。 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，丁丙诺啡用于治疗阿片类药物使用障碍的情况有所增加 戏剧性的，部分原因是与美沙酮相比，给药障碍更少。 尽管如此，患者对丁丙诺啡反应的变异性可能会导致一些患者失败 治疗。除了性别和同时服药等临床特征外， 影响患者对丁丙诺啡反应的变异性，遗传变异性可能是 阿片成瘾药物治疗反应的复杂表型。 尽管特定的药物原(OPRM1、OPRD1、UGT2B7和CYP3A4)已经 被证实可能有助于丁丙诺啡的反应，目前缺乏数据 西班牙裔人口。这种可解决的疏忽非常令人担忧，因为它将倾向于 加剧已经存在的影响拉美裔美国人的医疗差距 这项试点项目的目的是更好地了解 影响个体患者临床反应的药物遗传学变量 丁丙诺啡治疗阿片类药物使用障碍。通过测量丁丙诺啡血浆 水平和临床指标的治疗反应，我们将执行候选基因 联合研究以更好地了解相关的药源如何影响患者的预后 加勒比拉美裔人口正在接受阿片类药物使用障碍的治疗。的长期目标是 这项研究是为了开发以加勒比拉美裔为导向的DNA引导的治疗方法 治疗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.