Unraveling Catechol-O-Methyltransferase rs4680 SNP’s Role in Patients’ Response to Tramadol and Its Adverse Effects: A Pharmacogenetics Insight into Postoperative Pain Management

Effective postoperative pain management is essential for patient well-being and an efficient healthcare system. Variations in the Catechol O-Methyltransferase (COMT) gene, specifically rs4680, play a crucial role in pain perception and opioid response. This study seeks to elucidate the impact of rs4...

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Main Authors: Ammara Khan, Akbar Waheed, Tayyaba Afsar, Ali Abusharha, Huma Shafique, Suhail Razak
Format: Article
Language:English
Published: MDPI AG 2023-12-01
Series:Journal of Clinical Medicine
Subjects:
Online Access:https://www.mdpi.com/2077-0383/13/1/249
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author Ammara Khan
Akbar Waheed
Tayyaba Afsar
Ali Abusharha
Huma Shafique
Suhail Razak
author_facet Ammara Khan
Akbar Waheed
Tayyaba Afsar
Ali Abusharha
Huma Shafique
Suhail Razak
author_sort Ammara Khan
collection DOAJ
description Effective postoperative pain management is essential for patient well-being and an efficient healthcare system. Variations in the Catechol O-Methyltransferase (COMT) gene, specifically rs4680, play a crucial role in pain perception and opioid response. This study seeks to elucidate the impact of rs4680 polymorphism on tramadol efficacy and adverse reactions in post-surgical patients. We performed an uncontrolled cohort pharmacogenetics study in which participants underwent postoperative tramadol administration. The frequencies of rs4680 alleles were determined and the association between rs4680 genotypes and the efficacy of tramadol analgesic as pain relief, measured by the Numeric Rating Scale (NRS), was analyzed. Secondary outcomes included tramadol-induced sedation levels, opioid-induced nausea and vomiting, and other adverse effects of tramadol. Data analysis, using IBM SPSS Statistics 23, focused on pain and side effect differences across genotypes, with statistical significance set to <i>p</i> ≤ 0.05. The COMT (rs4680) genotype distribution exhibited a ‘G’ allele frequency of 41.5% and an ‘A’ allele frequency of 58.5%, with the AA genotype present in 44% of individuals, adhering to the Hardy–Weinberg equilibrium (<i>p</i> = 0.788). Patients with the AA genotype reported lower pain scores post-tramadol administration across all times examined (<i>p</i> < 0.001), but also experienced statistically significant (<i>p</i> < 0.001) higher incidences of tramadol-induced nausea, vomiting, and sedation. However, GG genotype individuals experienced poor pain relief from tramadol, requiring more supplemental analgesia. These significant findings underscore the critical role of COMT rs4680 polymorphism in response to tramadol and the necessity of a personalized approach to postoperative pain management.
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spelling doaj.art-9a580115db414a0da3ea97a859d1522c2024-01-10T15:01:47ZengMDPI AGJournal of Clinical Medicine2077-03832023-12-0113124910.3390/jcm13010249Unraveling Catechol-O-Methyltransferase rs4680 SNP’s Role in Patients’ Response to Tramadol and Its Adverse Effects: A Pharmacogenetics Insight into Postoperative Pain ManagementAmmara Khan0Akbar Waheed1Tayyaba Afsar2Ali Abusharha3Huma Shafique4Suhail Razak5Department of Pharmacology and Therapeutics, Nawaz Sharif Medical College, Gujrat 50700, PakistanDepartment of Pharmacology and Therapeutics, Islamic International Medical College, Riphah University, Islamabad 46000, PakistanDepartment of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11495, Saudi ArabiaDepartment of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh 11495, Saudi ArabiaInstitute of Cellular Medicine, Newcastle University Medical School, Newcastle University, Newcastle upon Tyne NE1 7RU, UKDepartment of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11495, Saudi ArabiaEffective postoperative pain management is essential for patient well-being and an efficient healthcare system. Variations in the Catechol O-Methyltransferase (COMT) gene, specifically rs4680, play a crucial role in pain perception and opioid response. This study seeks to elucidate the impact of rs4680 polymorphism on tramadol efficacy and adverse reactions in post-surgical patients. We performed an uncontrolled cohort pharmacogenetics study in which participants underwent postoperative tramadol administration. The frequencies of rs4680 alleles were determined and the association between rs4680 genotypes and the efficacy of tramadol analgesic as pain relief, measured by the Numeric Rating Scale (NRS), was analyzed. Secondary outcomes included tramadol-induced sedation levels, opioid-induced nausea and vomiting, and other adverse effects of tramadol. Data analysis, using IBM SPSS Statistics 23, focused on pain and side effect differences across genotypes, with statistical significance set to <i>p</i> ≤ 0.05. The COMT (rs4680) genotype distribution exhibited a ‘G’ allele frequency of 41.5% and an ‘A’ allele frequency of 58.5%, with the AA genotype present in 44% of individuals, adhering to the Hardy–Weinberg equilibrium (<i>p</i> = 0.788). Patients with the AA genotype reported lower pain scores post-tramadol administration across all times examined (<i>p</i> < 0.001), but also experienced statistically significant (<i>p</i> < 0.001) higher incidences of tramadol-induced nausea, vomiting, and sedation. However, GG genotype individuals experienced poor pain relief from tramadol, requiring more supplemental analgesia. These significant findings underscore the critical role of COMT rs4680 polymorphism in response to tramadol and the necessity of a personalized approach to postoperative pain management.https://www.mdpi.com/2077-0383/13/1/249catechol O-methyltransferase (COMT)tramadol painpostoperativeadverse drug reaction (ADR)pharmacogenetics
spellingShingle Ammara Khan
Akbar Waheed
Tayyaba Afsar
Ali Abusharha
Huma Shafique
Suhail Razak
Unraveling Catechol-O-Methyltransferase rs4680 SNP’s Role in Patients’ Response to Tramadol and Its Adverse Effects: A Pharmacogenetics Insight into Postoperative Pain Management
Journal of Clinical Medicine
catechol O-methyltransferase (COMT)
tramadol pain
postoperative
adverse drug reaction (ADR)
pharmacogenetics
title Unraveling Catechol-O-Methyltransferase rs4680 SNP’s Role in Patients’ Response to Tramadol and Its Adverse Effects: A Pharmacogenetics Insight into Postoperative Pain Management
title_full Unraveling Catechol-O-Methyltransferase rs4680 SNP’s Role in Patients’ Response to Tramadol and Its Adverse Effects: A Pharmacogenetics Insight into Postoperative Pain Management
title_fullStr Unraveling Catechol-O-Methyltransferase rs4680 SNP’s Role in Patients’ Response to Tramadol and Its Adverse Effects: A Pharmacogenetics Insight into Postoperative Pain Management
title_full_unstemmed Unraveling Catechol-O-Methyltransferase rs4680 SNP’s Role in Patients’ Response to Tramadol and Its Adverse Effects: A Pharmacogenetics Insight into Postoperative Pain Management
title_short Unraveling Catechol-O-Methyltransferase rs4680 SNP’s Role in Patients’ Response to Tramadol and Its Adverse Effects: A Pharmacogenetics Insight into Postoperative Pain Management
title_sort unraveling catechol o methyltransferase rs4680 snp s role in patients response to tramadol and its adverse effects a pharmacogenetics insight into postoperative pain management
topic catechol O-methyltransferase (COMT)
tramadol pain
postoperative
adverse drug reaction (ADR)
pharmacogenetics
url https://www.mdpi.com/2077-0383/13/1/249
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