药物遗传学引导的阿片类药物治疗改善慢性疼痛结果和并发性精神健康:一项随机,双盲,受控研究
Laura Agulló1,2, Isidro Aguado1, Javier Muriel1,2
1Pharmacogenetic Unit, Clinical Pharmacology Department, Alicante Institute for Health and Biomedical Research (ISABIAL), General University Hospital of Alicante, c/Pintor Baeza, 12, 03010 Alicante, Spain.
International journal of molecular sciences
|July 14, 2023
概括
药物遗传学引导的阿片类药物处方改善了慢性疼痛患者的疼痛缓解和生活质量. 与常规护理相比,基因型导向治疗减少了疼痛强度,不良事件和阿片类药物剂量.
科学领域:
- 药物遗传学 药物遗传学
- 疼痛管理 疼痛管理
- 临床药理学 临床药理学
背景情况:
- 对阿片类药物反应的个体间变异性与遗传多态性有关.
- 临床药物遗传学实施联盟 (CPIC) 为特定的基因药物对提供了建议.
- 治疗疼痛的药物遗传学研究的范围正在扩大.
研究的目的:
- 评估基因型导向阿片类药物处方在慢性疼痛患者的疗效.
- 为了比较由CYP2D6,OPRM1和COMT基因型指导的治疗臂和标准护理臂之间的结果.
主要方法:
- 一项随机临床试验,涉及60名慢性疼痛患者.
- 患者被随机分配到两个臂:一个由CYP2D6,OPRM1和COMT基因型指导,另一个由常规临床实践指导.
- 测量结果包括疼痛强度,疼痛缓解,生活质量,不良事件,阿片类药物剂量和健康效用.
主要成果:
- 基因型导向治疗显著降低疼痛强度 (76比59毫米),改善疼痛缓解 (28比48毫米).
- 在基因型导向组中,生活质量 (43比56毫米) 和健康效用得分显著更高.
- 与常规护理相比,这种方法降低了不良事件 (3 [1-5] vs 1 [0-2]) 和阿片类药物剂量 (42%的减少).
结论:
- 基因型指导的阿片类药物处方,考虑到CYP2D6,OPRM1和COMT,为慢性疼痛管理提供了显著的好处.
- 这种个性化的方法可以改善疼痛控制,提高生活质量,减少不良事件和阿片类药物剂量.
- 进一步的大规模实施和药物经济评估是临床翻译的必要条件.
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