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The utility of pharmacogenetic testing to support the treatment of bipolar disorder

机译:药物遗传学测试支持双相情感障碍的治疗

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Background: Bipolar disorder (BD) is a frequent cause of disability, health care costs, and risk of suicide. Pharmacogenetic tests (PGTs) could help clinicians to identify those patients predisposed to the occurrence of adverse events (AEs) improving the understanding of the correlation between genetic variants and drug response. Materials and methods: The study evaluated 30 patients affected by BD type I or II (according to Diagnostic and Statistical Manual of Mental Disorders, version 5 ) who underwent the PGT Neurofarmagen? (AB-BIOTICS SA, Barcelona, Spain) between March 2016 and March 2017. The primary aim of this study was to identify if the treatment prescribed by the psychiatrists was consistent with the treatment suggested by the PGT at T0 (corresponding to the test report communication). As a secondary aim, we wanted to assess if clinicians had changed the treatment (in case of discordance) at T1 (3-month follow-up visit) according to the results of the PGT. Results: At T0, only 4 patients (13%) had an optimal therapy in line with the PGT suggestions. At 3-month follow-up, 13 patients (40%) had received a change of therapy consistent to the test, showing a significant statistical improvement in the Clinical Global Impression item Severity (CGI-S) score over time compared to those not having changes consistent with the test. Regarding AEs, at baseline 9 out of 10 (90%) of the patients who received a therapy modification according to the test presented AEs, and a significant within-group reduction was observed after 3 months ( p = 0.031). Conclusion: Despite the small sample size, the study shows promising data about the usefulness of PGT to support clinicians in reaching a more effective and tolerated treatment in the routine approach of BD.
机译:背景:躁郁症(BD)是导致残疾,医疗保健费用和自杀风险的常见原因。药物遗传学测试(PGT)可以帮助临床医生识别那些容易发生不良事件(AE)的患者,从而加深对遗传变异与药物反应之间相关性的了解。材料和方法:该研究评估了30例接受了PGT Neurofarmagen ?(AB-BIOTICS SA,巴塞罗那,PD)的I型或II型BD患者(根据《精神障碍诊断和统计手册》第5版) ,西班牙)在2016年3月至2017年3月之间进行。本研究的主要目的是确定精神科医生规定的治疗是否与PGT在T0时建议的治疗一致(与测试报告通讯对应)。作为次要目标,我们想根据PGT的结果评估临床医生是否在T1(3个月的随访期)改变了治疗方法(如果出现不一致的情况)。结果:在T0时,只有4例患者(13%)符合PGT建议的最佳治疗方法。在3个月的随访中,有13例患者(40%)接受了与试验一致的治疗改变,与未接受治疗的患者相比,随着时间的推移,临床总体印象项目严重程度(CGI-S)评分显示出统计学上的显着改善变化与测试一致。关于AE,在根据该试验接受疗法修改的10位患者中,有9位(90%)出现AE,在3个月后观察到组内显着降低(p = 0.031)。结论:尽管样本量很小,但该研究显示有关PGT在支持BD常规方法中支持临床医生获得更有效和耐受的治疗方面的有用价值的数据。

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