| Autor: |
Delage, Clément, Darnaud, Léa, Etain, Bruno, Vignes, Marina, Ly, Tu-Ky, Frapsauce, Alexia, Veyrier, Marc, Delavest, Marine, Marlinge, Emeline, Hennion, Vincent, Meyrel, Manon, Jacob, Aude, Chouchana, Margot, Smati, Julie, Pataud, Guillaume, Khoudour, Nihel, Fontan, Jean-Eudes, Labat, Laurence, Bellivier, Frank, Lloret-Linares, Célia |
| Zdroj: |
Journal of Personalized Medicine; Nov2022, Vol. 12 Issue 11, p1869, 13p |
| Abstrakt: |
Altered cytochromes P450 enzymes (CYP) and P-glycoprotein transporter (P-gp) activity may explain variabilities in drug response. In this study, we analyzed four years of phenotypic assessments of CYP/P-gp activities to optimize pharmacotherapy in psychiatry. A low-dose probe cocktail was administered to evaluate CYP1A2, 2B6, 2D6, 2C9, 2C19, 3A4, and P-gp activities using the probe/metabolite concentration ratio in blood or the AUC. A therapeutic adjustment was suggested depending on the phenotyping results. From January 2017 to June 2021, we performed 32 phenotypings, 10 for adverse drug reaction, 6 for non-response, and 16 for both reasons. Depending on the CYP/P-gp evaluated, only 23% to 56% of patients had normal activity. Activity was decreased in up to 57% and increased in up to 60% of cases, depending on the CYP/P-gp evaluated. In 11/32 cases (34%), the therapeutic problem was attributable to the patient's metabolic profile. In 10/32 cases (31%), phenotyping excluded the metabolic profile as the cause of the therapeutic problem. For all ten individuals for which we had follow-up information, phenotyping allowed us to clearly state or clearly exclude the metabolic profile as a possible cause of therapeutic failure. Among them, seven showed a clinical improvement after dosage adaptation, or drug or pharmacological class switching. Our study confirmed the interest of CYP and P-gp phenotyping for therapeutic optimization in psychiatry. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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