实现重度抑郁症缓解所需的实际去甲文拉法辛剂量与药物遗传学预测剂量之间的一致性：一项为期10周的开放标签研究。
Concordance between actual and pharmacogenetic predicted desvenlafaxine dose needed to achieve remission in major depressive disorder: a 10-week open-label study.
作者信息
Bousman Chad A, Müller Daniel J, Ng Chee H, Byron Keith, Berk Michael, Singh Ajeet B
机构信息
Departments of aPsychiatry bGeneral Practice cFlorey Institute of Neuroscience and Mental Health, University of Melbourne dDepartment of Psychological Sciences, Centre for Human Psychopharmacology, Swinburne University of Technology, Hawthorne eMolecular Genetics, Healthscope Pathology fSchool of Medicine, IMPACT Strategic Research Centre, Deakin University, Geelong, Victoria, Australia gCentre for Addiction and Mental Health, Campbell Family Research Institute hDepartment of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
出版信息
Pharmacogenet Genomics. 2017 Jan;27(1):1-6. doi: 10.1097/FPC.0000000000000253.
BACKGROUND
Pharmacogenetic-based dosing support tools have been developed to personalize antidepressant-prescribing practice. However, the clinical validity of these tools has not been adequately tested, particularly for specific antidepressants.
OBJECTIVE
To examine the concordance between the actual dose and a polygene pharmacogenetic predicted dose of desvenlafaxine needed to achieve symptom remission.
MATERIALS AND METHODS
A 10-week, open-label, prospective trial of desvenlafaxine among Caucasian adults with major depressive disorder (n=119) was conducted. Dose was clinically adjusted and at the completion of the trial, the clinical dose needed to achieve remission was compared with the predicted dose needed to achieve remission.
RESULTS
Among remitters (n=95), there was a strong concordance (Kendall's τ-b=0.84, P=0.0001; Cohen's κ=0.82, P=0.0001) between the actual and the predicted dose need to achieve symptom remission, showing high sensitivity (≥85%), specificity (≥86%), and accuracy (≥89%) of the tool.
CONCLUSION
Findings provide initial evidence for the clinical validity of a polygene pharmacogenetic-based tool for desvenlafaxine dosing.
背景
基于药物遗传学的剂量支持工具已被开发出来，以实现抗抑郁药处方的个性化。然而，这些工具的临床有效性尚未得到充分测试，尤其是针对特定的抗抑郁药。
目的
研究去甲文拉法辛实际剂量与实现症状缓解所需的多基因药物遗传学预测剂量之间的一致性。
材料与方法
对119名患有重度抑郁症的白种成年人进行了一项为期10周的去甲文拉法辛开放标签前瞻性试验。临床调整剂量，并在试验结束时，将实现缓解所需的临床剂量与实现缓解所需的预测剂量进行比较。
结果
在缓解者（n = 95）中，实现症状缓解所需的实际剂量与预测剂量之间存在很强的一致性（肯德尔τ-b = 0.84，P = 0.0001；科恩κ = 0.82，P = 0.0001），表明该工具具有高敏感性（≥85%）、特异性（≥86%）和准确性（≥89%）。
结论
研究结果为基于多基因药物遗传学的去甲文拉法辛剂量工具的临床有效性提供了初步证据。
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