Volume 359, 15 August 2024, Pages 117-124Author links open overlay panel, , , , , Highlights•

Pharmacogenomic testing is available to guide the treatment of depression.

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Pharmacogenomic guided medication enhances remission and response rates.

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Pharmacogenomic guided medication reduces the occurrence of adverse effects.

AbstractBackground

Pharmacotherapy is one of the primary treatment modalities for depression. However, there is considerable variability in the individual response to antidepressant medications. Personalized medicine guided by pharmacogenomic testing may hold promise in addressing this issue.

Methods

In this study, 665 depressive patients were randomly enrolled into two groups: the pharmacogenomic testing group (n = 333) and the control group (n = 332). In the testing group, participants underwent pharmacogenomic testing, and clinicians customized the treatment plan with the result, while the control group relied solely on clinicians' experience. The primary outcomes were the proportion of remission and response, assessed with Hamilton Depression Rating Scale (HDRS). The secondary outcomes included changes in HDRS scores over time and frequency of adverse drug reactions by the participants.

Results

At week 8, the pharmacogenomic testing group showed significantly higher remission rates (24.0 % v.s. 15.1 %; RR = 1.117; P = 0.007) and response rates (39.3 % v.s. 25.7 %; RR = 1.225; P < 0.001) compared to the control group. By week 12, the pharmacogenomic testing group continued to demonstrate significant advantages in remission (31.0 % v.s. 20.0 %; RR = 1.159; P = 0.003) and response (48.7 % v.s. 37.3 %; RR = 1.224; P = 0.006). Additionally, adverse drug reactions were less frequent in the pharmacogenomic testing group.

Limitations

This study is not blind to clinicians and it's a single-center study.

Conclusions: Pharmacogenomic testing-guided drug therapy can provide greater assistance in the treatment of depression.

AbbreviationsHDRS

Hamilton Depression Rating Scale

CYP

Cytochrome P450 proteins

SLC6A4

Solute Carrier Family 6 Member 4

HTR2A

5-Hydroxytryptamine Receptor 2 A

GADL1

Recombinant Glutamate Decarboxylase Like Protein 1

GRIA2

Recombinant Glutamate Receptor, Ionotropic, AMPA 2

UGT2B15

UDP glucuronosyltransferase 2 family, polypeptide B15

PharmGKB

Pharmacogenomics Knowledge Base

CPIC

Clinical Pharmacogenetics Implementation Consortium

DPWG

Dutch Pharmacogenetics Working Group

TDM

Therapeutical Drug Monitoring

TESS

Treatment Emergent Symptom Scale

SSRI

Selective Serotonin Reuptake Inhibitor

SNRI

Serotonin and Noradrenaline Reuptake Inhibitor

Keywords

Pharmacogenomics

Precision medicine

Depression

Psychiatric

Pharmacotherapy

© 2024 The Authors. Published by Elsevier B.V.