Please use this identifier to cite or link to this item: https://hdl.handle.net/11000/31400

Pharmacogenetics and prediction of adverse events in prescription opioid use disorder patients


no-thumbnailView/Open:

 Pharmacogenetics and prediction of adverse events in.pdf



596,5 kB
Adobe PDF
Share:

This resource is restricted

Title:
Pharmacogenetics and prediction of adverse events in prescription opioid use disorder patients
Authors:
Muriel, Javier  
Margarit, César
Barrachina, Jordi
Ballester, Purificación
Flor, Andrea  
Morales, Domingo
Horga, José F.
Fernández, Eduardo
Peiró, Ana
Editor:
Wiley
Department:
Departamentos de la UMH::Farmacología, Pediatría y Química Orgánica
Issue Date:
2018
URI:
https://hdl.handle.net/11000/31400
Abstract:
The threats involved in the long-term opioid treatment of chronic non-cancer pain (CNCP) have increased notably. Strategies to identify at-risk patients are important because there is no clear evidence showing which screening or deprescription programmes are appropriate. Our aim was to evaluate the evidence provided by pharmacogenetics applied to predict an analgesic toxicity profile in prescription opioid use disorder (POUD) patients participating in an opioid deprescription programme. Pharmacogenetic markers were analysed in an observational, prospective deprescription programme for POUD patients (n = 88) treated for CNCP. It consisted of monitoring visits (baseline, follow-up and final), opioid rotation or discontinuation and the recording of adverse events and suspected adverse drug reactions (ADRs). Variants in OPRM1 (A118G), ABCB1 (C3435T), COMT (G472A), OPRD1 (T921C) and ARRB2 (C8622T) genes were tested by real-time PCR. Ethics committee approved the study. Wild-type OPRM1-AA genotype carriers reported a significantly higher number of adverse events than OPRM1-AG/GG (median [p25-75], 7 [5-11] vs 5 [3-9]), particularly gastrointestinal system events (90% vs 63%) such as nausea (33% vs 0%). Suspected ADRs (affecting 17% of the patients) were three times higher in males than in females (30% vs 11%). The deprescription programme was effective and safe, and it achieved a significant progressive reduction in the morphine equivalent daily dose, strong opioids and other analgesics' use, without causing any changes in pain intensity or opiate abstinence syndrome. OPRM1 gene polymorphisms could identify the risk of gastrointestinal adverse events in POUD patients. Deprescription programmes including pharmacogenetic analysis should be considered during the follow-up of this population.
Keywords/Subjects:
adverse events
chronic pain
opioid use disorder
pharmacogenetics
prescription opioids
Type of document:
application/pdf
Access rights:
info:eu-repo/semantics/closedAccess
Attribution-NonCommercial-NoDerivatives 4.0 Internacional
DOI:
https://doi.org/10.1111/bcpt.13155
Appears in Collections:
Artículos Farmacología, Pediatría y Química Orgánica



Creative Commons ???jsp.display-item.text9???