Effectiveness of a Pharmacogenetic Tool at Improving Treatment Efficacy in Major Depressive Disorder: A Meta-Analysis of Three Clinical Studies
Por:
Vilches, S, Tuson, M, Vieta, E, Alvarez, E, Espadaler, J
Publicada:
1 sep 2019
Resumen:
Several pharmacogenetic tests to support drug selection in psychiatric patients have recently become available. The current meta-analysis aimed to assess the clinical utility of a commercial pharmacogenetic-based tool for psychiatry (Neuropharmagen) in the treatment management of depressive patients. Random-effects meta-analysis of clinical studies that had examined the effect of this tool on the improvement of depressive patients was performed. Effects were summarized as standardized differences between treatment groups. A total of 450 eligible subjects from three clinical studies were examined. The random effects model estimated a statistically significant effect size for the pharmacogenetic-guided prescription (d = 0.34, 95% CI = 0.11-0.56, p-value = 0.004), which corresponded to approximately a 1.8-fold increase in the odds of clinical response for pharmacogenetic-guided vs. unguided drug selection. After exclusion of patients with mild depression, the pooled estimated effect size increased to 0.42 (95% CI = 0.19-0.65, p-value = 0.004, n = 287), corresponding to an OR = 2.14 (95% CI = 1.40-3.27). These results support the clinical utility of this pharmacogenetic-based tool in the improvement of health outcomes in patients with depression, especially those with moderate-severe depression. Additional pragmatic RCTs are warranted to consolidate these findings in other patient populations.
Filiaciones:
Vilches, S:
AB Biot SA, Av Torre Blanca 57, Barcelona 08172, Catalonia, Spain
Tuson, M:
AB Biot SA, Av Torre Blanca 57, Barcelona 08172, Catalonia, Spain
Vieta, E:
Inst Neurosci, Dept Psychiat & Psychol, C Villaroel 170, Barcelona 08036, Catalonia, Spain
Univ Barcelona, Inst Invest Biomed August Pi & Sunyer IDIBAPS, C Rossello 149, E-08036 Barcelona, Catalonia, Spain
Ctr Invest Biomed Red Salud Mental CIBERSAM, Av Monforte de Lemos 3-5, Madrid 28029, Spain
Alvarez, E:
Hosp Santa Creu & Sant Pau, Serv Psiquiatria, C St Antoni Maria Claret 167, Barcelona 08025, Catalonia, Spain
Univ Autonoma Barcelona, Inst Invest Biomed St Pau, Barcelona 08025, Catalonia, Spain
Espadaler, J:
AB Biot SA, Av Torre Blanca 57, Barcelona 08172, Catalonia, Spain
Gold, Green Published
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