Pediatric CYP2D6 metabolizer status and post‐tonsillectomy nausea and vomiting after ondansetron
Abstract The goal of this study was to determine whether CYP2D6 metabolizer status within the ondansetron‐treated pediatric tonsillectomy population is associated with risk of postoperative nausea and vomiting (PONV) in the post‐anesthesia care unit. We conducted a retrospective cohort study of pedi...
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2023-02-01
|
| Series: | Clinical and Translational Science |
| Online Access: | https://doi.org/10.1111/cts.13447 |
| _version_ | 1811164865957462016 |
|---|---|
| author | Katherine Black B. Randall Brenn Andrea Gaedigk Jonathan P. Wanderer Sara L. Van Driest |
| author_facet | Katherine Black B. Randall Brenn Andrea Gaedigk Jonathan P. Wanderer Sara L. Van Driest |
| author_sort | Katherine Black |
| collection | DOAJ |
| description | Abstract The goal of this study was to determine whether CYP2D6 metabolizer status within the ondansetron‐treated pediatric tonsillectomy population is associated with risk of postoperative nausea and vomiting (PONV) in the post‐anesthesia care unit. We conducted a retrospective cohort study of pediatric patients (<18 years) who underwent tonsillectomy and received ondansetron on the day of the procedure. Data were obtained from BioVU, an institutional biobank that links DNA to de‐identified electronic health record data. Subjects were tested for 10 CYP2D6 allelic variants and copy number variation, and genotype data translated into CYP2D6 metabolizer status. The cohort included 652 individuals, 105 (16.1%) of whom had PONV. Rates of PONV were similar across groups: ultrarapid metabolizers (UMs), 1 of 9 (11.1%); normal metabolizers (NMs), 64 of 354 (18.1%); intermediate metabolizers (IMs), 33 of 234 (14.1%); poor metabolizers (PMs), 6 of 39 (15.4%); and ambiguous phenotypes, 1 of 16 (6.3%). In multivariable analysis adjusted for age, sex, and time under anesthesia, CYP2D6 metabolizer status was not associated with PONV, with an odds ratio of 1.37 (95% confidence interval 0.9, 2.1) when comparing PM/IM versus NM/UM. In this large pediatric population, no significant differences were detected for PONV based on CYP2D6 metabolizer status. Further investigation is needed to determine mechanisms for ondansetron inefficacy in children. |
| first_indexed | 2024-04-10T15:29:07Z |
| format | Article |
| id | doaj.art-712ce31a96b04aaeb38118a38cf6f444 |
| institution | Directory Open Access Journal |
| issn | 1752-8054 1752-8062 |
| language | English |
| last_indexed | 2024-04-10T15:29:07Z |
| publishDate | 2023-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Clinical and Translational Science |
| spelling | doaj.art-712ce31a96b04aaeb38118a38cf6f4442023-02-14T07:32:57ZengWileyClinical and Translational Science1752-80541752-80622023-02-0116226927810.1111/cts.13447Pediatric CYP2D6 metabolizer status and post‐tonsillectomy nausea and vomiting after ondansetronKatherine Black0B. Randall Brenn1Andrea Gaedigk2Jonathan P. Wanderer3Sara L. Van Driest4Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology, and Nutrition Vanderbilt University Medical Center Nashville Tennessee USADivision of Pediatric Anesthesia Shriner's Hospitals for Children‐Philadelphia Philadelphia Pennsylvania USADivision of Clinical Pharmacology, Toxicology & Therapeutic Innovation, Children's Mercy Kansas City and Department of Pediatrics University of Missouri‐Kansas City Kansas City Missouri USADepartments of Anesthesiology and Biomedical Informatics Vanderbilt University Medical Center Nashville Tennessee USADepartments of Pediatrics and Medicine, and the Center for Pediatric Precision Medicine Vanderbilt University Medical Center Nashville Tennessee USAAbstract The goal of this study was to determine whether CYP2D6 metabolizer status within the ondansetron‐treated pediatric tonsillectomy population is associated with risk of postoperative nausea and vomiting (PONV) in the post‐anesthesia care unit. We conducted a retrospective cohort study of pediatric patients (<18 years) who underwent tonsillectomy and received ondansetron on the day of the procedure. Data were obtained from BioVU, an institutional biobank that links DNA to de‐identified electronic health record data. Subjects were tested for 10 CYP2D6 allelic variants and copy number variation, and genotype data translated into CYP2D6 metabolizer status. The cohort included 652 individuals, 105 (16.1%) of whom had PONV. Rates of PONV were similar across groups: ultrarapid metabolizers (UMs), 1 of 9 (11.1%); normal metabolizers (NMs), 64 of 354 (18.1%); intermediate metabolizers (IMs), 33 of 234 (14.1%); poor metabolizers (PMs), 6 of 39 (15.4%); and ambiguous phenotypes, 1 of 16 (6.3%). In multivariable analysis adjusted for age, sex, and time under anesthesia, CYP2D6 metabolizer status was not associated with PONV, with an odds ratio of 1.37 (95% confidence interval 0.9, 2.1) when comparing PM/IM versus NM/UM. In this large pediatric population, no significant differences were detected for PONV based on CYP2D6 metabolizer status. Further investigation is needed to determine mechanisms for ondansetron inefficacy in children.https://doi.org/10.1111/cts.13447 |
| spellingShingle | Katherine Black B. Randall Brenn Andrea Gaedigk Jonathan P. Wanderer Sara L. Van Driest Pediatric CYP2D6 metabolizer status and post‐tonsillectomy nausea and vomiting after ondansetron Clinical and Translational Science |
| title | Pediatric CYP2D6 metabolizer status and post‐tonsillectomy nausea and vomiting after ondansetron |
| title_full | Pediatric CYP2D6 metabolizer status and post‐tonsillectomy nausea and vomiting after ondansetron |
| title_fullStr | Pediatric CYP2D6 metabolizer status and post‐tonsillectomy nausea and vomiting after ondansetron |
| title_full_unstemmed | Pediatric CYP2D6 metabolizer status and post‐tonsillectomy nausea and vomiting after ondansetron |
| title_short | Pediatric CYP2D6 metabolizer status and post‐tonsillectomy nausea and vomiting after ondansetron |
| title_sort | pediatric cyp2d6 metabolizer status and post tonsillectomy nausea and vomiting after ondansetron |
| url | https://doi.org/10.1111/cts.13447 |
| work_keys_str_mv | AT katherineblack pediatriccyp2d6metabolizerstatusandposttonsillectomynauseaandvomitingafterondansetron AT brandallbrenn pediatriccyp2d6metabolizerstatusandposttonsillectomynauseaandvomitingafterondansetron AT andreagaedigk pediatriccyp2d6metabolizerstatusandposttonsillectomynauseaandvomitingafterondansetron AT jonathanpwanderer pediatriccyp2d6metabolizerstatusandposttonsillectomynauseaandvomitingafterondansetron AT saralvandriest pediatriccyp2d6metabolizerstatusandposttonsillectomynauseaandvomitingafterondansetron |