Pharmacogenetic tests to guide drug treatment in depression: Comparison of the available testing kits and clinical trials

Progress in Neuro-psychopharmacology & Biological Psychiatry
Chiara FabbriAlessandro Serretti

Abstract

The empirical approach to drug choice and dosing in depression often results into inadequate response and side effects. Pharmacogenetic (PGx) testing appears a promising way to implement personalized treatments. A systematic review was performed to identify available PGx tests, compare the genes they include with clinical guidelines and drug labels, and assess the quality of published clinical studies. ~40 commercial PGx tests are available and potential benefits were estimated for nine of them by clinical studies. The most part of studies are observational (9/21) or non-randomized case-control trials that compared standard care with PGx-guided treatment (6/21), six randomized controlled trials (RCTs) are available. The only genes included in all the available PGx tests and with recommendations in current clinical guidelines and drug labels are CYP2D6 and CYP2C19. There is heterogeneity among outcome measures across studies (response, remission, improvement, health care utilization, medication tolerability), as well as in trial design. Relatively weak clinical benefits were reported by RCTs and higher clinical benefits by non-RCTs, but the last group showed greater risk of bias. Lack of patient and rater's blindness, retrospect...Continue Reading

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Citations

Jan 22, 2020·Clinical Psychopharmacology and Neuroscience : the Official Scientific Journal of the Korean College of Neuropsychopharmacology·Chiara Fabbri, Alessandro Serretti
Apr 30, 2020·Revista brasileira de psiquiatria : orgão oficial da Associação Brasileira de Psiquiatria, Asociación Psiquiátrica de la América Latina·Erika L Nurmi
Aug 29, 2019·Psychiatry Investigation·Filippo CorponiAlessandro Serretti
Aug 28, 2020·International Journal of Psychiatry in Clinical Practice·Raffaella ZanardiAlessandro Serretti
Oct 5, 2019·Clinical Pharmacology and Therapeutics·Chiara Fabbri, Alessandro Serretti
Jul 16, 2020·International Journal of Molecular Sciences·Hee-Ju KangJae-Min Kim
Oct 16, 2018·Frontiers in Pharmacology·Shusuke NumataRyota Hashimoto
Oct 31, 2020·Clinical Psychopharmacology and Neuroscience : the Official Scientific Journal of the Korean College of Neuropsychopharmacology·Chiara Fabbri, Alessandro Serretti
Jan 29, 2021·Clinical Psychopharmacology and Neuroscience : the Official Scientific Journal of the Korean College of Neuropsychopharmacology·Kyung Ho LeeChi-Un Pae
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May 29, 2021·Clinical Pharmacology and Therapeutics·Raffaella ZanardiChiara Fabbri

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