CYP2C19和CYP2D6对阿里皮普拉和RISPERIDONE的副作用的影响:系统性审查
Emma de Brabander1, Kristian Kleine Schaars2, Therese van Amelsvoort1
1Mental Health and Neuroscience Research Institute, Department of Psychiatry and Neuropsychology, Maastricht University Medical Centre, the Netherlands.
Journal of psychiatric research
|April 17, 2024
概括
细胞染色体P450 (CYP) 酶如CYP2D6和CYP2C19的遗传变异可能会影响抗精神病副作用. 目前对阿里皮普拉和RISPERIDONE的研究受到研究质量和样本规模的限制,这阻碍了最终的结论.
科学领域:
- 药物遗传学 药物遗传学
- 心理药理学 心理药理学
- 临床药房 临床药房
背景情况:
- 肝细胞P450 (CYP) 酶的变异性,特别是CYP2C19和CYP2D6,可能会影响抗精神病药物结果.
- 阿里皮普拉和RISPERIDONE是被广泛使用的抗精神病药物,其中CYP2D6是主要的代谢途径.
研究的目的:
- 审查CYP2C19和CYP2D6对阿里皮普拉和RISPERIDONE副作用的影响.
- 批判性地评估现有药物遗传学研究中的方法限制.
- 确定有关CYP酶对抗精神病药物不良事件的影响的文献上的空白.
主要方法:
- 在六个主要的电子数据库中进行了符合PRISMA的系统文献搜索.
- 从最初的2007年出版物中,包括了34项研究阿里皮普拉和RISPERIDONE的药物遗传学研究.
- 用纽卡斯尔-太华尺度 (NOS) 和修订后的Cochrane风险偏见工具来评估文献质量.
主要成果:
- 所有34项研究都集中在CYP2D6;只有一个研究了CYP2C19,发现与RISPERIDONE的神经副作用的关联.
- 大多数研究报告称,CYP2D6和副作用结果之间没有显著的关系.
- 评估的研究显示出方法上的弱点,包括RCT和小样本大小存在偏差的高风险,限制了数据合成.
结论:
- 目前关于CYP2C19和CYP2D6对阿里皮普拉和RISPERIDONE的影响的药理学文献不足以得出最终的结论.
- 异质性,小样本规模和研究设计问题困扰着现有研究.
- 需要大规模的随机试验和强大的方法来澄清这些CYP酶在抗精神病药物遗传学中的作用.
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