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Published on: August 11, 2015
Brain-derived neurotrophic factor Val66Met polymorphism and remission after antidepressant treatment in depressed
Nora Cassam Sulliman1, Céline Verstuyft2, Kenneth Chappell3
1MOODS Team, INSERM UMR 1018, CESP, Faculté de Médecine, Université Paris-Saclay, Le Kremlin Bicêtre F-94275, France; Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Hôpital de Bicêtre, Le Kremlin Bicêtre F-94275, France; Service de Génétique Moléculaire, Pharmacogénétique et Hormonologie de Bicêtre, Hôpitaux Universitaires Paris-Saclay, Assistance Publique-Hôpitaux de Paris, Hôpital de Bicêtre, Paris, F-94275, France.
Introduction:
Major depressive disorder (MDD) is a leading global health concern. Personalized medicine could enable a better response to antidepressants. Findings suggested optimal response genotypes of Val66Met genetic polymorphism of brain-derived neurotrophic factor (BDNF) (rs6265) in Caucasian depressed patients: selective serotonin reuptake inhibitors (SSRIs) associated with better clinical improvement in Val/Val homozygotes and selective norepinephrine reuptake inhibitors (SNRIs) or tricyclic antidepressants (TCAs) with better clinical improvement in Met-allele carriers. We aim to replicate these findings with a meta-analysis.
Methods:
A systematic search of PubMed was performed. All included studies assessed the efficacy of one antidepressant class (SSRIs, SNRIs, or TCAs) in Caucasian patients with a major depressive episode (MDE) in the context of MDD according to BDNF Val66Met genotypes. The primary outcome was remission (MADRS ≤ 12 or HAMD ≤ 7); secondary outcomes were changes from baseline HAMD or MADRS scores and response (≥ 50% reduction).
Results:
Seven studies were included. In total, 599 patients (357 Val/Val homozygotes and 242 Met-allele carriers) were analyzed. No significant association between optimal response genotypes and remission (190 (56.4%) in the optimal and 146 (54.3%) in the non-optimal genotype response group; fixed effects model: RR = 1.02, 95% CI [0.89; 1.18], p = 0.78) was observed. Similar results were observed for score changes and response. Sensitivity analyses confirmed these findings. Statistical power for primary outcome was 95%.
Conclusion:
We showed no significant association between the expected optimal response genotype of the BDNF Val66Met polymorphism and clinical improvement after antidepressant treatment in Caucasian depressed patients.
