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Improved Antidepressant Remission in Major Depression via a Pharmacokinetic Pathway Polygene Pharmacogenetic Report

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Objective: Major depressive disorder (MDD) is projected to be a leading cause of disability globally by 2030. Only a minority of patients remit with antidepressants. If assay of polymorphisms influencing central nervous system (CNS) bioavailability could guide prescribers to more effectively dose patients, remission rates may improve and the burden of disease from MDD reduce. Hepatic and blood brain barrier (BBB) polymorphisms appear to influence antidepressant CNS bioavailability. Methods: A 12-week prospective double blind randomized genetically guided versus unguided trial of antidepressant dosing in Caucasian adults with MDD (n=148) was conducted. Results: Subjects receiving genetically guided prescribing had a 2.52-fold greater chance of remission (95% confidence interval [CI]=1.71-3.73, z=4.66, p<0.0001). The number needed to genotype (NNG)=3 (95% CI=1.7-3.5) to produce an additional remission. Conclusion: These data suggest that a pharmacogenetic dosing report (CNSDoseⓇ) improves antidepressant efficacy. The effect size was sufficient that translation to clinical care may arise if results are independently replicated.

Abstract

Objective: Major depressive disorder (MDD) is projected to be a leading cause of disability globally by 2030. Only a minority of patients remit with antidepressants. If assay of polymorphisms influencing central nervous system (CNS) bioavailability could guide prescribers to more effectively dose patients, remission rates may improve and the burden of disease from MDD reduce. Hepatic and blood brain barrier (BBB) polymorphisms appear to influence antidepressant CNS bioavailability. Methods: A 12-week prospective double blind randomized genetically guided versus unguided trial of antidepressant dosing in Caucasian adults with MDD (n=148) was conducted. Results: Subjects receiving genetically guided prescribing had a 2.52-fold greater chance of remission (95% confidence interval [CI]=1.71-3.73, z=4.66, p<0.0001). The number needed to genotype (NNG)=3 (95% CI=1.7-3.5) to produce an additional remission. Conclusion: These data suggest that a pharmacogenetic dosing report (CNSDoseⓇ) improves antidepressant efficacy. The effect size was sufficient that translation to clinical care may arise if results are independently replicated.

참고문헌 (63)

  1. Mathers CD., "Projections of global mortality and burden of disease from 2002 to 2030", PLoS Med, 3, pp.e442~ (2006)
  2. Murray CJ., "Disability-adjusted life years(DALYs)for 291 diseases and injuries in 21 regions, 1990-2010 : a systematic analysis for the Global Burden of Disease Study 2010", Lancet, 380, pp.2197~2223 (2012)
  3. Fournier JC., "Antidepressant drug effects and depression severity : a patient-level meta-analysis", JAMA, 303, pp.47~53 (2010)
  4. Nierenberg AA., "Definitions of antidepressant treatment response, remission, nonresponse, partial response, and other relevant outcomes: a focus on treatment-resistant depression", J Clin Psychiatry, 62(Suppl 16), pp.5~9 (2001)
  5. Moncrieff J., "Efficacy of antidepressants in adults", BMJ, 331, pp.155~157 (2005)
  6. Trivedi MH., "Evaluation of outcomes with citalopram for depression using measurement-based care in STAR*D : implications for clinical practice", Am J Psychiatry, 163, pp.28~40 (2006)
  7. Amsterdam JD., "Treatment algorithms in treatment-resistant depression", Psychiatr Clin North Am, 19, pp.371~386 (1996)
  8. Greden JF., "The burden of disease for treatment-resistant depression", J Clin Psychiatry, 62(Suppl 16), pp.26~31 (2001)
  9. hase ME., "Remission rates following antidepressant therapy with bupropion or selective serotonin reuptake inhibitors : a meta-analysis of original data from 7 randomized controlled trials", J Clin Psychiatry, 66, pp.974~981 (2005)
  10. Rush AJ., "Acute and longer-term outcomes in depressed outpatients requiring one or several treatment steps : a STAR*D report", Am J Psychiatry, 163, pp.1905~1917 (2006)
  11. Nierenberg AA., "Evolution of remission as the new standard in the treatment of depression", J Clin Psychiatry, 60(Suppl 22), pp.7~11 (1999)
  12. Frank E., "Conceptualization and rationale for consensus definitions of terms in major depressive disorder. Remission, recovery, relapse, and recurrence", Arch Gen Psychiatry, 48, pp.851~855 (1991)
  13. Thase ME., "Remission with mirtazapine and selective serotonin reuptake inhibitors : a meta-analysis of individual patient data from 15 controlled trials of acute phase treatment of major depression", Int Clin Psychopharmacol, 25, pp.189~198 (2010)
  14. Singh A., "Pharmacogenomics--the potential of genetically guided prescribing", Aust Fam Physician, 36, pp.820~824 (2007)
  15. Singh A., "Genetically guided prescribing : Hope or hype?", Acta Neuropsychiatr, 20, pp.50~51 (2008)
  16. Singh AB., "Antidepressant pharmacogenetics", Curr Opin Psychiatry, 27, pp.43~51 (2014)
  17. Winner JG., "A prospective, randomized, double-blind study assessing the clinical impact of integrated pharmacogenomic testing for major depressive disorder", Discov Med, 16, pp.219~227 (2013)
  18. Shelton RC., "Intracellular mechanisms of antidepressant drug action", Harv Rev Psychiatry, 8, pp.161~174 (2000)
  19. Malberg JE., "Antidepressant action : to the nucleus and beyond", Trends Pharmacol Sci, 26, pp.631~638 (2005)
  20. Belmaker RH., "Major depressive disorder", N Engl J Med, 358, pp.55~68 (2008)
  21. Porcelli S., "Meta-analysis of serotonin transporter gene promoter polymorphism(5-HTTLPR)association with antidepressant efficacy", Eur Neuropsychopharmacol, 22, pp.239~258 (2012)
  22. Keers R., "Interaction between serotonin transporter gene variants and life events predicts response to antidepressants in the GENDEP project", Pharmacogenomics J, 11, pp.138~145 (2011)
  23. Domschke K., "Serotonin transporter gene hypomethylation predicts impaired antidepressant treatment response", Int J Neuropsychopharmacol, 17, pp.1167~1176 (2014)
  24. Dutheil F., "ABC transporters and cytochromes P450 in the human central nervous system : influence on brain pharmacokinetics and contribution to neurodegenerative disorders", Expert Opin Drug Metab Toxicol, 6, pp.1161~1174 (2010)
  25. Kirchheiner J., "Pharmacogenetics of antidepressants and antipsychotics : the contribution of allelic variations to the phenotype of drug response", Mol Psychiatry, 9, pp.442~473 (2004)
  26. Singh AB., "ABCB1 polymorphism predicts escitalopram dose needed for remission in major depression", Transl Psychiatry, 2, pp.e198~ (2012)
  27. Hicks JK., "Clinical Pharmacogenetics Implementation Consortium guideline for CYP2D6 and CYP2C19 genotypes and dosing of tricyclic antidepressants", Clin Pharmacol Ther, 93, pp.402~408 (2013)
  28. Preskorn S., "Comparison of the pharmacokinetics of venlafaxine extended release and desvenlafaxine in extensive and poor cytochrome P450 2D6 metabolizers", J Clin Psychopharmacol, 29, pp.39~43 (2009)
  29. Nichols AI., "The absolute bioavailability of desvenlafaxine in healthy subjects", J Bioequiv Availab, 4, pp.18~23 (2012)
  30. Thase ME., "An integrated analysis of the efficacy of desvenlafaxine compared with placebo in patients with major depressive disorder", CNS Spectr, 14, pp.144~154 (2009)
  31. Linnet K., "A review on the impact of P-glycoprotein on the penetration of drugs into the brain. Focus on psychotropic drugs", Eur Neuropsychopharmacol, 18, pp.157~169 (2008)
  32. Hartz AM., "ABC transporters in the CNS-an inventory", Curr Pharm Biotechnol, 12, pp.656~673 (2011)
  33. Juliano RL., "A surface glycoprotein modulating drug permeability in Chinese hamster ovary cell mutants", Biochim Biophys Acta, 455, pp.152~162 (1976)
  34. Chen CJ., "Internal duplication and homology with bacterial transport proteins in the mdr1(P-glycoprotein)gene from multidrug-resistant human cells", Cell, 47, pp.381~389 (1986)
  35. Callen DF., "Localization of the human multiple drug resistance gene, MDR1, to 7q21. 1", Hum Genet, 77, pp.142~144 (1987)
  36. Isenbarger TA., "The most conserved genome segments for life detection on Earth and other planets", Orig Life Evol Biosph, 38, pp.517~533 (2008)
  37. Eyal S., "Regional P-glycoprotein activity and inhibition at the human blood-brain barrier as imaged by positron emission tomography", Clin Pharmacol Ther, 87, pp.579~585 (2010)
  38. Hoffmeyer S., "Functional polymorphisms of the human multidrug-resistance gene : multiple sequence variations and correlation of one allele with P-glycoprotein expression and activity in vivo", Proc Natl Acad Sci U S A, 97, pp.3473~3478 (2000)
  39. Kimchi-Sarfaty C., "A"silent"polymorphism in the MDR1 gene changes substrate specificity", Science, 315, pp.525~528 (2007)
  40. Weiss J., "Inhibition of P-glycoprotein by newer antidepressants", J Pharmacol Exp Ther, 305, pp.197~204 (2003)
  41. Uhr M., "Polymorphisms in the drug transporter geneABCB1 predict antidepressant treatment response in depression", Neuron, 57, pp.203~209 (2008)
  42. Uhr M., "Penetration of amitriptyline, but not of fluoxetine, into brain is enhanced in mice with blood-brain barrier deficiency due to mdr1a P-glycoprotein gene disruption", Neuropsychopharmacology, 22, pp.380~387 (2000)
  43. Wang JS., "Sertraline and its metabolite desmethylsertraline, but not bupropion or its three major metabolites, have high affinity for P-glycoprotein", Biol Pharm Bull, 31, pp.231~234 (2008)
  44. Kato M., "ABCB1(MDR1)gene polymorphisms are associated with the clinical response to paroxetine in patients with major depressive disorder", Prog Neuropsychopharmacol Biol Psychiatry, 32, pp.398~404 (2008)
  45. Lin KM., "ABCB1 gene polymorphisms are associated with theseverity of major depressive disorder and its response to escitalopram treatment", Pharmacogenet Genomics, 21, pp.163~170 (2011)
  46. Lee SH., "MRP1 polymorphisms associated with citalopram response in patients with major depression", J Clin Psychopharmacol, 30, pp.116~125 (2010)
  47. Jia J., "Regulation and dysregulation of 3'UTR-mediated translational control", Curr Opin Genet Dev, 23, pp.29~34 (2013)
  48. Bushra R., "Food-drug interactions", Oman Med J, 26, pp.77~83 (2011)
  49. Tsai HH., "Evaluation of documented drug interactions and contraindications associated with herbs and dietary supplements : a systematic literature review", Int J Clin Pract, 66, pp.1056~1078 (2012)
  50. Akamine Y., "Psychotropic drug-drug interactions involving P-glycoprotein", CNS Drugs, 26, pp.959~973 (2012)
  51. Tod M., "Impact of genetic polymorphism on drug-drug interactions mediated by cytochromes : a general approach", AAPS J, 15, pp.1242~1252 (2013)
  52. Crettol S., "Pharmacogenomics in psychiatry : from therapeutic drug monitoring to genomic medicine", Clin Pharmacol Ther, 95, pp.254~257 (2014)
  53. Spudich A., "Inhibition of multidrug resistance transporter-1 facilitates neuroprotective therapies after focal cerebral ischemia", Nat Neurosci, 9, pp.487~488 (2006)
  54. Hermann DM., "Implications of ATP-binding cassette transporters for brain pharmacotherapies", Trends Pharmacol Sci, 28, pp.128~134 (2007)
  55. Kilic E., "ABCC1 : a gateway for pharmacological compounds to the ischaemic brain", Brain, 131, pp.2679~2689 (2008)
  56. ElAli A., "Apolipoprotein E controls ATPbinding cassette transporters in the ischemic brain", Sci Signal, 3, pp.ra72~ (2010)
  57. ElAli A., "Apolipoprotein-E controls adenosine triphosphate-binding cassette transporters ABCB1 and ABCC1 on cerebral microvessels after methamphetamine intoxication", Stroke, 43, pp.1647~1653 (2012)
  58. ElAli A., "Liver X receptor activation enhances blood-brain barrier integrity in the ischemic brain and increases the abundance of ATP-binding cassette transporters ABCB1 and ABCC1 on brain capillary cells", Brain Pathol, 22, pp.175~187 (2012)
  59. Cartwright TA., "Mrp1 is essential for sphingolipid signaling to p-glycoprotein in mouse blood-brain and blood-spinal cord barriers", J Cereb Blood Flow Metab, 33, pp.381~388 (2013)
  60. Tao LY., "Cediranib(recentin, AZD2171)reverses ABCB1-and ABCC1-mediated multidrug resistance by inhibition of their transport function", Cancer Chemother Pharmacol, 64, pp.961~969 (2009)
  61. Crisafulli C., "Case-control association study of 36 single-nucleotide polymorphisms within 10 candidate genes for major depression and bipolar disorder", Psychiatry Res, 209, pp.121~123 (2013)
  62. Niitsu T., "Pharmacogenetics in major depression : a comprehensive meta-analysis", Prog Neuropsychopharmacol Biol Psychiatry, 45, pp.183~194 (2013)
  63. Thompson C., "Psychiatrist attitudes towards pharmacogenetic testing, direct-to-consumer genetic testing, and integrating genetic counseling into psychiatric patient care", Psychiatry Res (2014)

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