Título : Pharmacogenetic Guided Opioid Therapy Improves Chronic Pain Outcomes and Comorbid Mental Health: A Randomized, Double-Blind, Controlled Study |
Autor : Agulló, Laura ![](/image/ORCID.jpg) Aguado, Isidro ![](/image/ORCID.jpg) Muriel, Javier ![](/image/ORCID.jpg) Margarit, César Gómez, Alba Escorial, Mónica ![](/image/ORCID.jpg) Sánchez, Astrid ![](/image/ORCID.jpg) Fernández, Alicia Peiró, Ana ![](/image/ORCID.jpg) |
Editor : MDPI |
Departamento: Departamentos de la UMH::Farmacología, Pediatría y Química Orgánica |
Fecha de publicación: 2023 |
URI : https://hdl.handle.net/11000/31404 |
Resumen :
Interindividual variability in analgesic response is at least partly due to well-characterized polymorphisms that are associated with opioid dosing and adverse outcomes. The Clinical Pharmacogenetics Implementation Consortium (CPIC) has put forward recommendations for the CYP2D6 phenotype, but the list of studied drug-gene pairs continues to grow. This clinical trial randomized chronic pain patients (n = 60), referred from primary care to pain unit care into two opioid prescribing arms, one guided by CYP2D6, μ-opioid receptor (OPRM1), and catechol-O-methyl transferase (COMT) genotypes vs. one with clinical routine. The genotype-guided treatment reduced pain intensity (76 vs. 59 mm, p < 0.01) by improving pain relief (28 vs. 48 mm, p < 0.05), increased quality of life (43 vs. 56 mm p < 0.001), and lowered the incidence of clinically relevant adverse events (3 [1-5] vs. 1 [0-2], p < 0.01) and 42% opioid dose (35 [22-61] vs. 60 [40-80] mg/day, p < 0.05) as opposed to usual prescribing arm. The final health utility score was significantly higher (0.71 [0.58-0.82] vs. 0.51 [0.13-0.67] controls, p < 0.05) by improving sleepiness and depression comorbidity, with a significant reduction of 30-34% for headache, dry mouth, nervousness, and constipation. A large-scale implementation analysis could help clinical translation, together with a pharmaco-economic evaluation.
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Palabras clave/Materias: pharmacogenetics CYP2D6 OPRM1 COMT opioids chronic pain |
Tipo documento : application/pdf |
Derechos de acceso: info:eu-repo/semantics/openAccess Attribution-NonCommercial-NoDerivatives 4.0 Internacional |
DOI : 10.3390/ijms241310754. |
Aparece en las colecciones: Artículos Farmacología, Pediatría y Química Orgánica
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