用精神活性药物治疗的儿童和青少年的基因药物治疗
Ruud H J Verstegen1, Iris Cohn1, Mark E Feldman1
1Canadian Paediatric Society, Drug Therapy Committee, Ottawa, Ontario, Canada.
Paediatrics & child health
|September 16, 2024
概括
药物遗传学 (PGx) 测试提供个性化心理健康治疗,但证据有限,特别是在儿童中. 本指南帮助临床医生使用PGx测试用于精神活性药物,重点关注药物代谢和不良反应.
科学领域:
- 药物基因组学 药物基因组学
- 儿童和青少年精神病学
- 临床药理学 临床药理学
背景情况:
- 精神活性药物越来越多地被处方用于儿科精神健康状况.
- 对这些药物的个人反应各不相同,需要精准医学方法.
- 药物遗传学 (PGx) 测试正在成为个性化治疗的工具,许多公司提供这些服务.
研究的目的:
- 为儿童和青少年心理活性药物的PGx测试的临床使用和解释提供指导.
- 概述将PGx测试纳入临床实践的实际步骤和资源.
- 解决当前科学证据的局限性,特别是在儿科患者群体中.
主要方法:
- 对影响药物代谢的药物基因变异 (例如,CYP450酶) 的现有实践指南的审查.
- 鉴定遗传变异 (例如,HLA类型,POLG变异) 和对特定抗药物的不良药物反应之间的关联.
- 评估对影响药物标蛋白的遗传变异的证据.
主要成果:
- 对于影响某些抗精神病药物,抗抑郁药物和抗药物的药物度的药物基因变异 (例如,CYP2C19,CYP2D6,CYP2C9) 存在实践指南.
- 特定的遗传标记 (HLA,POLG) 与某些抗药物的不良反应有关.
- 对影响药物标的遗传变异的证据仍然有限,使改变治疗反应的预测变得复杂.
结论:
- 根据药物代谢酶基因型,PGx测试可以为特定的精神活性药物提供药物选择和剂量.
- 虽然已经确立了与不良药物反应的一些关联,但PGx在儿科心理健康中的实用性证据仍在发展.
- 需要进一步的研究,以充分利用PGx测试来优化青少年的精神活性药物治疗.
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