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Un estudio caso-control sobre el uso individualizado de analgésicos opiáceos basado en el polimorfismo de un solo

Jing Yang^1,2, Lei Zheng¹, Fu Zheng²

¹Department of Pharmacy, Shandong Provincial Third Hospital, Cheeloo College of Medicine, Shandong University, Jinan, China.

Frontiers in pharmacology

|August 28, 2025

Resumen

Las variaciones genéticas en OPRM1 están relacionadas con el aumento de las reacciones adversas a los medicamentos en pacientes que toman analgésicos opioides. Se necesitan estrategias de medicación personalizadas, especialmente para los portadores del genotipo OPRM1 AA, para mejorar la seguridad y la eficacia.

Área de la Ciencia:

Farmacogenómica
Farmacología clínica
La genética

Sus antecedentes:

Los analgésicos opioides son ampliamente utilizados para el control del dolor.
Los polimorfismos genéticos pueden influir en la eficacia del fármaco y en las reacciones adversas al fármaco.
Los enfoques de medicación personalizados son cruciales para optimizar el tratamiento con opiáceos.

Objetivo del estudio:

Investigar la asociación entre los polimorfismos genéticos y la eficacia y las reacciones adversas de los analgésicos opioides.
Mejorar la seguridad de los medicamentos y promover estrategias de tratamiento personalizadas.
Identificar variantes genéticas específicas que predicen el riesgo de ERA y guían la dosificación.

Principales métodos:

Revisión sistemática de la medicina basada en la evidencia para identificar los loci genéticos relevantes.
Estudio caso-control en el que participaron 480 pacientes, divididos en grupos de reacciones adversas y grupos de dosis requerida.
Genotipado de los genes objetivo (CYP2D6, CYP3A5*3, ABCB1, OPRM1) y análisis estadístico utilizando SPSS y SNPStats.

Principales resultados:

Se encontró una asociación significativa entre el genotipo OPRM1 (rs1799971, A>G) AA y el aumento de la incidencia de reacciones adversas (P < 0,05).
Los pacientes con el genotipo OPRM1 AA mostraron una mayor proporción de ADR en el grupo de observación en comparación con el grupo de control.
No se observaron diferencias significativas en la distribución del genotipo para la demanda de dosis, pero ABCB1 (rs1045642, C>T) justifica una investigación adicional.

Conclusiones:

El genotipo OPRM1 AA está asociado con un mayor riesgo de reacciones adversas a los analgésicos opioides.
Los pacientes con genotipo OPRM1 AA requieren un monitoreo cuidadoso para detectar reacciones adversas y dosis iniciales potencialmente más bajas.
Se necesita más investigación en cohortes más grandes para confirmar la asociación entre los polimorfismos genéticos y la demanda de dosis de opioides, con un enfoque en el gen ABCB1.

Palabras clave:

reacciones adversas al fármaco demanda de dosis del fármaco Analgésicos opiáceos medicación personalizada polimorfismo de un solo nucleótido

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