Effectiveness of a Pharmacogenetic Tool at Improving Treatment Efficacy in Major Depressive Disorder: A Meta-Analysis of Three Clinical Studies

Several pharmacogenetic tests to support drug selection in psychiatric patients have recently become available. The current meta-analysis aimed to assess the clinical utility of a commercial pharmacogenetic-based tool for psychiatry (Neuropharmagen<sup>&#174;</sup>) in the treatment...

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Bibliographic Details
Main Authors: Silvia Vilches, Miquel Tuson, Eduard Vieta, Enric Álvarez, Jordi Espadaler
Format: Article
Language:English
Published: MDPI AG 2019-09-01
Series:Pharmaceutics
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Online Access:https://www.mdpi.com/1999-4923/11/9/453
Description
Summary:Several pharmacogenetic tests to support drug selection in psychiatric patients have recently become available. The current meta-analysis aimed to assess the clinical utility of a commercial pharmacogenetic-based tool for psychiatry (Neuropharmagen<sup>&#174;</sup>) in the treatment management of depressive patients. Random-effects meta-analysis of clinical studies that had examined the effect of this tool on the improvement of depressive patients was performed. Effects were summarized as standardized differences between treatment groups. A total of 450 eligible subjects from three clinical studies were examined. The random effects model estimated a statistically significant effect size for the pharmacogenetic-guided prescription (<i>d</i> = 0.34, 95% CI = 0.11&#8722;0.56, <i>p</i>-value = 0.004), which corresponded to approximately a 1.8-fold increase in the odds of clinical response for pharmacogenetic-guided vs. unguided drug selection. After exclusion of patients with mild depression, the pooled estimated effect size increased to 0.42 (95% CI = 0.19&#8722;0.65, <i>p</i>-value = 0.004, <i>n</i> = 287), corresponding to an OR = 2.14 (95% CI = 1.40&#8722;3.27). These results support the clinical utility of this pharmacogenetic-based tool in the improvement of health outcomes in patients with depression, especially those with moderate&#8722;severe depression. Additional pragmatic RCTs are warranted to consolidate these findings in other patient populations.
ISSN:1999-4923