Pharmacist-guided pre-emptive pharmacogenetic testing in antidepressant therapy (PrePGx): study protocol for an open-label, randomized controlled trial
Abstract Background It is known that only 50% of patients diagnosed with major depressive disorders (MDD) respond to the first-line antidepressant treatment. Accordingly, there is a need to improve response rates to reduce healthcare costs and patient suffering. One approach to increase rates of tre...
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| Format: | Article |
| Language: | English |
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BMC
2021-12-01
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| Series: | Trials |
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| Online Access: | https://doi.org/10.1186/s13063-021-05724-5 |
| _version_ | 1819009477357076480 |
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| author | Céline K. Stäuble Markus L. Lampert Samuel Allemann Martin Hatzinger Kurt E. Hersberger Henriette E. Meyer zu Schwabedissen Christian Imboden Thorsten Mikoteit |
| author_facet | Céline K. Stäuble Markus L. Lampert Samuel Allemann Martin Hatzinger Kurt E. Hersberger Henriette E. Meyer zu Schwabedissen Christian Imboden Thorsten Mikoteit |
| author_sort | Céline K. Stäuble |
| collection | DOAJ |
| description | Abstract Background It is known that only 50% of patients diagnosed with major depressive disorders (MDD) respond to the first-line antidepressant treatment. Accordingly, there is a need to improve response rates to reduce healthcare costs and patient suffering. One approach to increase rates of treatment response might be the integration of pharmacogenetic (PGx) testing to stratify antidepressant drug selection. The goal of PGx assessments is to identify patients who have an increased risk to experience adverse drug reactions or non-response to specific drugs. Especially for antidepressants, there is compiling evidence on PGx influencing drug exposure as well as response. Methods This study is an open-label, randomized controlled trial conducted in two study centers in Switzerland: (1) the Psychiatric Clinic of Solothurn and (2) the Private Clinic Wyss in Münchenbuchsee. Adult inpatients diagnosed with a unipolar moderate or severe depressive episode are recruited at clinic admission and are included in the study. If the adjustment to a new antidepressant pharmacotherapy is necessary, the participants are randomized to either Arm A (intervention group) or Arm B (control group). If no new antidepressant pharmacotherapy is introduced the participants will be followed up in an observational arm. The intervention is the service of pharmacist-guided pre-emptive PGx testing to support clinical decision making on antidepressant selection and dosing. As a comparison, in the control group, the antidepressant pharmacotherapy is selected by the treating physician according to current treatment guidelines (standard of care) without the knowledge of PGx test results and support of clinical pharmacists. The primary outcome of this study compares the response rates under antidepressant treatment after 4 weeks between intervention and control arm. Discussion The findings from this clinical trial are expected to have a direct impact on inter-professional collaborations for the handling and use of PGx data in psychiatric practice. Trial registration ClinicalTrials.gov NCT04507555 . Registered on August 11, 2020. Swiss National Clinical Trials Portal SNCTP000004015 . Registered August 18, 2020. |
| first_indexed | 2024-12-21T00:56:59Z |
| format | Article |
| id | doaj.art-69ee103aed3d4f669c669ca859af720a |
| institution | Directory Open Access Journal |
| issn | 1745-6215 |
| language | English |
| last_indexed | 2024-12-21T00:56:59Z |
| publishDate | 2021-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Trials |
| spelling | doaj.art-69ee103aed3d4f669c669ca859af720a2022-12-21T19:21:16ZengBMCTrials1745-62152021-12-0122111110.1186/s13063-021-05724-5Pharmacist-guided pre-emptive pharmacogenetic testing in antidepressant therapy (PrePGx): study protocol for an open-label, randomized controlled trialCéline K. Stäuble0Markus L. Lampert1Samuel Allemann2Martin Hatzinger3Kurt E. Hersberger4Henriette E. Meyer zu Schwabedissen5Christian Imboden6Thorsten Mikoteit7Biopharmacy, Department of Pharmaceutical Sciences, University of BaselPharmaceutical Care, Department of Pharmaceutical Sciences, University of BaselPharmaceutical Care, Department of Pharmaceutical Sciences, University of BaselPsychiatric Services Solothurn, Solothurner Spitäler AG and Faculty of Medicine, University of BaselPharmaceutical Care, Department of Pharmaceutical Sciences, University of BaselBiopharmacy, Department of Pharmaceutical Sciences, University of BaselPrivate Clinic WyssPsychiatric Services Solothurn, Solothurner Spitäler AG and Faculty of Medicine, University of BaselAbstract Background It is known that only 50% of patients diagnosed with major depressive disorders (MDD) respond to the first-line antidepressant treatment. Accordingly, there is a need to improve response rates to reduce healthcare costs and patient suffering. One approach to increase rates of treatment response might be the integration of pharmacogenetic (PGx) testing to stratify antidepressant drug selection. The goal of PGx assessments is to identify patients who have an increased risk to experience adverse drug reactions or non-response to specific drugs. Especially for antidepressants, there is compiling evidence on PGx influencing drug exposure as well as response. Methods This study is an open-label, randomized controlled trial conducted in two study centers in Switzerland: (1) the Psychiatric Clinic of Solothurn and (2) the Private Clinic Wyss in Münchenbuchsee. Adult inpatients diagnosed with a unipolar moderate or severe depressive episode are recruited at clinic admission and are included in the study. If the adjustment to a new antidepressant pharmacotherapy is necessary, the participants are randomized to either Arm A (intervention group) or Arm B (control group). If no new antidepressant pharmacotherapy is introduced the participants will be followed up in an observational arm. The intervention is the service of pharmacist-guided pre-emptive PGx testing to support clinical decision making on antidepressant selection and dosing. As a comparison, in the control group, the antidepressant pharmacotherapy is selected by the treating physician according to current treatment guidelines (standard of care) without the knowledge of PGx test results and support of clinical pharmacists. The primary outcome of this study compares the response rates under antidepressant treatment after 4 weeks between intervention and control arm. Discussion The findings from this clinical trial are expected to have a direct impact on inter-professional collaborations for the handling and use of PGx data in psychiatric practice. Trial registration ClinicalTrials.gov NCT04507555 . Registered on August 11, 2020. Swiss National Clinical Trials Portal SNCTP000004015 . Registered August 18, 2020.https://doi.org/10.1186/s13063-021-05724-5PharmacogenomicsDepressionAntidepressantPharmaceutical carePsychiatry |
| spellingShingle | Céline K. Stäuble Markus L. Lampert Samuel Allemann Martin Hatzinger Kurt E. Hersberger Henriette E. Meyer zu Schwabedissen Christian Imboden Thorsten Mikoteit Pharmacist-guided pre-emptive pharmacogenetic testing in antidepressant therapy (PrePGx): study protocol for an open-label, randomized controlled trial Trials Pharmacogenomics Depression Antidepressant Pharmaceutical care Psychiatry |
| title | Pharmacist-guided pre-emptive pharmacogenetic testing in antidepressant therapy (PrePGx): study protocol for an open-label, randomized controlled trial |
| title_full | Pharmacist-guided pre-emptive pharmacogenetic testing in antidepressant therapy (PrePGx): study protocol for an open-label, randomized controlled trial |
| title_fullStr | Pharmacist-guided pre-emptive pharmacogenetic testing in antidepressant therapy (PrePGx): study protocol for an open-label, randomized controlled trial |
| title_full_unstemmed | Pharmacist-guided pre-emptive pharmacogenetic testing in antidepressant therapy (PrePGx): study protocol for an open-label, randomized controlled trial |
| title_short | Pharmacist-guided pre-emptive pharmacogenetic testing in antidepressant therapy (PrePGx): study protocol for an open-label, randomized controlled trial |
| title_sort | pharmacist guided pre emptive pharmacogenetic testing in antidepressant therapy prepgx study protocol for an open label randomized controlled trial |
| topic | Pharmacogenomics Depression Antidepressant Pharmaceutical care Psychiatry |
| url | https://doi.org/10.1186/s13063-021-05724-5 |
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