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Concordance between actual and pharmacogenetic predicted desvenlafaxine dose needed to achieve remission in major depressive disorder: a 10-week open-label study

机译:在重度抑郁症中达到缓解所需的实际与药理遗传学预测地斯拉法辛剂量之间的一致性:一项为期10周的开放标签研究

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摘要

Background Pharmacogenetic-based dosing support tools have been developed to personalize antidepressant-prescribing practice. However, the clinical validity of these tools has not been adequately tested, particularly for specific antidepressants. Objective To examine the concordance between the actual dose and a polygene pharmacogenetic predicted dose of desvenlafaxine needed to achieve symptom remission. Materials and methods A 10-week, open-label, prospective trial of desvenlafaxine among Caucasian adults with major depressive disorder (n=119) was conducted. Dose was clinically adjusted and at the completion of the trial, the clinical dose needed to achieve remission was compared with the predicted dose needed to achieve remission. Results Among remitters (n=95), there was a strong concordance (Kendall\u27s τ-b=0.84, P=0.0001; Cohen\u27s κ=0.82, P=0.0001) between the actual and the predicted dose need to achieve symptom remission, showing high sensitivity (≥85%), specificity (≥86%), and accuracy (≥89%) of the tool. Conclusion Findings provide initial evidence for the clinical validity of a polygene pharmacogenetic-based tool for desvenlafaxine dosing.
机译:背景技术已经开发了基于药物遗传学的剂量支持工具来个性化抗抑郁药处方实践。但是,这些工具的临床有效性尚未得到充分测试,特别是对于特定的抗抑郁药。目的探讨desvenlafaxine的实际剂量与多基因药物遗传预测剂量之间的一致性,以达到症状缓解的目的。材料和方法进行了一项为期10周的开放性前瞻性试验,在患有严重抑郁症(n = 119)的白种人成年人中进行了去甲文拉法辛治疗。对剂量进行了临床调整,在试验完成时,将实现缓解所需的临床剂量与实现缓解所需的预计剂量进行了比较。结果在缓解者(n = 95)中,达到症状所需的实际剂量与预测剂量之间存在很强的一致性(Kendall \ u27sτ-b= 0.84,P = 0.0001; Cohen \ u27sκ= 0.82,P = 0.0001)。缓解,显示工具的高灵敏度(≥85%),特异性(≥86%)和准确性(≥89%)。结论研究结果为基于多基因药物遗传学的去甲文拉法辛给药工具的临床有效性提供了初步证据。

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