Improved efficacy with targeted pharmacogenetic-guided treatment of patients with depression and anxiety: A randomized clinical trial demonstrating clinical utility
Rattachement africain : us. Niveau de preuve : code pays fourni par la source.
Le résumé fourni par la source
The objective of this study was to evaluate the effect of pharmacogenetics-guided treatment on patients diagnosed with depression and/or anxiety, in a diverse set of clinical settings, as compared to the standard of care. The trial design followed a prospective, randomized, subject- and rater-blinded approach enrolling 685 patients from clinical providers specializing in Psychiatry, Internal Medicine, Obstetrics & Gynecology, and Family Medicine. The NeuroIDgenetix® test uses a genetic variant panel of ten genes, along with concomitant medications, to make medication management recommendations based on gene-drug and drug-drug interactions for over 40 medications used in the treatment of depression and anxiety. Pharmacogenetic testing was performed at the initial screening visit and baseline patient assessments were determined using the 17-item Hamilton Rating Scale for Depression (HAM-D17) and the Hamilton Rating Scale for Anxiety (HAM-A). Following enrollment and randomization, pharmacogenetic results for subjects assigned to the experimental group were provided to physicians to guide treatment selection, while control subjects were treated according to the usual standard of care. HAM-D17 and HAM-A assessments were collected at 4 weeks, 8 weeks, and 12 weeks after baseline to assess the efficacy of therapeutic selection. In patients diagnosed with depression, response rates (p = 0.001; OR: 4.72 [1.93–11.52]) and remission rates (p = 0.02; OR: 3.54 [1.27–9.88]) were significantly higher in the pharmacogenetics-guided group as compared to the control group at 12 weeks. In addition, patients in the experimental group diagnosed with anxiety showed a meaningful improvement in HAM-A scores at both 8 and 12 weeks (p = 0.02 and 0.02, respectively), along with higher response rates (p = 0.04; OR: 1.76 [1.03–2.99]). From these results, we conclude that pharmacogenetic-guided medication selection significantly improves outcomes of patients diagnosed with depression or anxiety, in a variety of healthcare settings.
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Improved efficacy with targeted pharmacogenetic-guided treatment of patients with depression and anxiety: A randomized clinical trial demonstrating clinical utility
- Date Crossref
- 01/01/2018
- Éditeur
- Elsevier BV
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
-
Mercer University Internal Medicine pays non établi dans la noticeUniversité ou école supérieure
-
Memorial Health University Medical Center pays non établi dans la noticeÉtablissement de santé
-
Meridian Clinical Research pays non établi dans la noticeStructure de recherche
-
Artemis (United States) pays non établi dans la noticeEntreprise
-
Creighton University United States pays non établi dans la noticeUniversité ou école supérieure
-
HealthPartners pays non établi dans la noticeOrganisation à but non lucratif
-
University of Nebraska Medical Center pays non établi dans la noticeÉtablissement de santé
-
AltheaDx (United States) pays non établi dans la noticeEntreprise
-
Relaro Medical Trials pays non établi dans la noticeInstitution
-
Artemis Institute for Clinical Research pays non établi dans la noticeStructure de recherche
-
Midwest Health Partners pays non établi dans la noticeInstitution
Internal Medicine — Mercer University, Memorial Health University Medical Center et Meridian Clinical Research, avec 8 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.