药物代谢酶药物遗传学变异为常见精神障碍的抗抑郁药物治疗方法提供了信息:系统性审查和元分析
Chenchula Santenna1, Atal Shubham1, Jhaj Ratinder1
1Department of Pharmacology, All India Institute of Medical Sciences-Bhopal, Madhya Pradesh 462020, India.
Journal of affective disorders
|September 12, 2024
概括
药物遗传学引导的抗抑郁药治疗改善了抑郁症和焦虑症的缓解率. 与通常治疗相比,这种方法也显著减少了不良药物事件.
科学领域:
- 药物基因组学 药物基因组学
- 精神病学是一个精神病学.
- 临床药理学 临床药理学
背景情况:
- 像抑郁症和焦虑症这样的常见精神障碍 (CMD) 往往对标准抗抑郁药疗法表现出不充分的反应,影响30-50%的患者.
- 确定治疗反应的预测因素对于优化患者的治疗结果至关重要.
研究的目的:
- 为了评估药物代谢酶的药物基因变异信息治疗 (PGxIT) 与常规抗抑郁药治疗 (UT) 在CMD患者中的疗效和安全性.
主要方法:
- 在主要数据库 (MEDLINE,Scopus,Cochrane Library) 进行了系统的文献搜索,直到2024年1月.
- 包括的研究集中在CMD诊断,DME基因变异,抗抑郁药的使用,并比较PGxIT与UT在人类受试者.
- 数据提取和质量评估由两位独立审查员进行,并使用随机和固定效应模型进行元分析,以估计聚合风险比率.
主要成果:
- 该审查包括了18项研究,涉及7021名参与者.
- 与UT相比,PGxIT在8周和12周的抑郁症和焦虑症症状缓解方面显示出显著更高的疗效,与UT相比.
- 药物不良事件在PGxIT组 (RR=0.65) 与UT组相比显著减少,证据的确定性中等.
结论:
- 药物遗传学引导的抗抑郁药治疗,利用药物代谢酶的遗传变异,为抑郁症和焦虑症的症状缓解提供了卓越的疗效.
- 与标准治疗方案相比,这种个性化的方法还可以显著减少药物不良事件.
- 研究结果支持PGxIT在改善常见精神障碍患者治疗结果方面的临床实用性.
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