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药物遗传学干预改善了难治性自闭症谱系障碍患者的治疗效果。

Pharmacogenetic Interventions Improve the Clinical Outcome of Treatment-Resistant Autistic Spectrum Disorder Sufferers.

作者信息

Arranz Maria J, Salazar Juliana, Bote Valentin, Artigas-Baleri Alicia, Serra-LLovich Alexandre, Triviño Emma, Roige Jordi, Lombardia Carlos, Cancino Martha, Hernandez Marta, Cendros Marc, Duran-Tauleria Enric, Maraver Natalia, Hervas Amaia

机构信息

Fundació Docència i Recerca Mútua Terrassa, 08221 Terrassa, Spain.

Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), 28029 Madrid, Spain.

出版信息

Pharmaceutics. 2022 May 6;14(5):999. doi: 10.3390/pharmaceutics14050999.

Abstract

BACKGROUND

Autistic spectrum disorders (ASD) are severe neurodevelopmental alterations characterised by deficits in social communication and repetitive and restricted behaviours. About a third of patients receive pharmacological treatment for comorbid symptoms. However, 30-50% do not respond adequately and/or present severe and long-lasting side effects.

METHODS

Genetic variants in , , and were investigated in N = 42 ASD sufferers resistant to pharmacological treatment. Clinical recommendations based on their pharmacogenetic profiles were provided within 24-48 h of receiving a biological sample.

RESULTS

A total of 39 participants (93%) improved after the pharmacogenetic intervention according to their CGI scores (difference in basal-final scores: 2.26, SD 1.55) and 37 participants (88%) according to their CGAS scores (average improvement of 20.29, SD 11.85). Twenty-three of them (55%) achieved symptom stability (CGI ≤ 3 and CGAS improvement ≥ 20 points), requiring less frequent visits to their clinicians and hospital stays. Furthermore, the clinical improvement was higher than that observed in a control group (N = 62) with no pharmacogenetic interventions, in which 66% responded to treatment (difference in CGI scores: -0.87, SD 9.4, = 1 × 10; difference in CGAS scores: 6.59, SD 7.76, = 5 × 10).

CONCLUSIONS

The implementation of pharmacogenetic interventions has the potential to significantly improve the clinical outcomes in severe comorbid ASD populations with drug treatment resistance and poor prognosis.

摘要

背景

自闭症谱系障碍(ASD)是严重的神经发育障碍,其特征为社交沟通缺陷以及重复和受限行为。约三分之一的患者因共病症状接受药物治疗。然而,30 - 50%的患者反应不佳和/或出现严重且持久的副作用。

方法

对42名对药物治疗耐药的ASD患者的、、和基因变异进行了研究。在收到生物样本后的24 - 48小时内,根据他们的药物遗传学特征提供了临床建议。

结果

根据临床总体印象量表(CGI)评分,共有39名参与者(93%)在药物遗传学干预后有所改善(基础 - 最终评分差异:2.26,标准差1.55);根据临床总体印象变化量表(CGAS)评分,37名参与者(88%)有所改善(平均改善20.29,标准差11.85)。其中23名(55%)实现了症状稳定(CGI≤3且CGAS改善≥20分),减少了看诊频率和住院时间。此外,临床改善程度高于未进行药物遗传学干预的对照组(N = 62),对照组中66%的患者对治疗有反应(CGI评分差异: - 0.87,标准差9.4, = 1×10;CGAS评分差异:6.59,标准差7.76, = 5×10)。

结论

药物遗传学干预的实施有可能显著改善药物治疗耐药且预后不良的重度共病ASD人群的临床结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7c05/9143818/93cc425f8728/pharmaceutics-14-00999-g001.jpg

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