药物遗传学测试是否可以优化抗抑郁药在严重抑郁症中有效的效果? 来自现实世界临床环境中的双盲随机对照试验的数据
Alessandra Minelli1,2, Stefano Barlati3,4, Stefano Bignotti5
1Department of Molecular and Translational Medicine, https://ror.org/02q2d2610University of Brescia, Brescia, Italy.
概括
药物遗传学 (PGx) 测试没有显著改善主要抑郁症 (MDD) 的整体抗抑郁药治疗. 然而,PGx指南显示,对严重的MDD症状和特定的症状领域有好处.
科学领域:
- 精神病学是一个精神病学.
- 药物遗传学 药物遗传学
- 临床试验 临床试验
背景情况:
- 大型抑郁症 (MDD) 的治疗反应是高度可变的.
- 药物遗传学 (PGx) 测试旨在个性化抗抑郁药物 (AD) 治疗.
- 在MDD中PGx测试的临床实用性仍在争论中.
研究的目的:
- 评估PGx引导治疗与MDD患者的标准护理之间的疗效.
- 用标准化抑郁和焦虑量表来评估临床结果.
主要方法:
- 一个前性,随机的,盲控试验 (PANDORA试验) 涉及268名MDD患者.
- 照常治疗 (TAU) 与使用遗传测试指南 (TGTG) 治疗组的比较.
- 在基线和4,8,12周使用HAM-D17,BDI-II,BAI,MINI-ICF-APP和UKU进行评估.
主要成果:
- 两组患者在12周内均出现显著的症状改善.
- 在TAU和TGTG组之间,总体反应或缓解率没有显著差异.
- 在4周和8周后,TGTG组对神经素质症状的改善更大.
- 在TGTG组中,具有严重基线症状的患者在8周后出现了更大的症状减少和更高的反应率.
结论:
- 与TAU相比,PGx测试没有显著提高MDD整体治疗疗效.
- PGx指导可能有利于特定的患者亚组,包括那些有严重症状的患者.
- 对于PGx测试在管理MDD中神经植物性症状的潜力.
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