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Gender based differences, pharmacogenetics and adverse events in chronic pain management


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Título :
Gender based differences, pharmacogenetics and adverse events in chronic pain management
Autor :
Planelles, Beatriz
Margarit, César
Inda, María del Mar
Ballester, Purificación
Muriel, Javier  
Barrachina, Jordi  
Ajo Ferrer, Raquel  
Esteban, maría Dolores
Peiró, Ana  
Editor :
Nature portfolio
Departamento:
Departamentos de la UMH::Farmacología, Pediatría y Química Orgánica
Fecha de publicación:
2020-04
URI :
https://hdl.handle.net/11000/32353
Resumen :
Safety data in chronic non-cancer pain (CNCP) with long-term opioid therapy has been poorly studied and can be differently influenced by gender. Furthermore, pharmacogenetics (PGx) could possibly be used to tailor pain medication based on the individual's genetic background. The aim was to assess whether PGx applied to a pharmacovigilance system could help to improve a patient's security profile. A pharmacovigilance data recording system was conducted over 24 months, including genotyping of OPRM1 variants (opioid receptor, A118G) and COMT (enzyme that degrades catecholamines such as norepinephrine, G1947A). Pain intensity (visual analogue scale, VAS), morphine equivalent daily dose (MEDD), adverse events (AEs) and suspected adverse drug reactions (ADRs) were recorded and analysed by gender. The Ethics Committee approved the study and data were analysed with R 3.6.0 software. A total of 748 patients were recruited in the study (67% female, VAS 62 ± 29 mm, MEDD 119 ± 114 mg/day) reporting a median of 6 (3.5-9) AEs/patient. Women presented more nausea, headaches, insomnia, loss of appetite, weight change, depression and dizziness than men. Analysis by genotype demonstrated that PGx influenced the prevalence of vomiting and depression in men, dizziness in women and sexual dysfunction in both. Physicians notified 150 ADRs mostly in females (79%) related to nervous system disorders. PGx applied to a pharmacovigilance recording system provides important information to achieve a better knowledge about AEs in CNCP pharmacological therapy. OPRM1 and COMT polymorphisms were associated with AEs in CNCP patients that differed according to gender.
Área de conocimiento :
CDU: Ciencias aplicadas: Medicina: Farmacología. Terapéutica. Toxicología. Radiología
Tipo documento :
application/pdf
Derechos de acceso:
info:eu-repo/semantics/closedAccess
DOI :
https://doi.org/10.1038/s41397-019-0118-9
Aparece en las colecciones:
Artículos Farmacología, Pediatría y Química Orgánica



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