1. A survival of the fittest strategy for the selection of genotypes by which drug responders and non-responders can be predicted in small groups.
- Author
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Höhle D, van Rooij K, Bloemers J, Pfaus JG, Michiels F, Janssen P, Claassen E, and Tuiten A
- Subjects
- Adult, Double-Blind Method, Female, Humans, Surveys and Questionnaires, Survival Analysis, Genotype, Selection, Genetic, Sexual Dysfunctions, Psychological drug therapy, Sexual Dysfunctions, Psychological genetics
- Abstract
Phenotype Prediction Scores (PPS) might be powerful tools to predict traits or the efficacy of treatments based on combinations of Single-Nucleotide Polymorphism (SNPs) in large samples. We developed a novel method to produce PPS models for small samples sizes. The set of SNPs is first filtered on those known to be relevant in biological pathways involved in a clinical condition, and then further filtered repeatedly in a survival strategy to select stabile positive/negative risk alleles. This method is applied on Female Sexual Interest/Arousal Disorder (FSIAD), for which two subtypes has been proposed: 1) a relatively insensitive excitatory system in the brain for sexual cues, and 2) a dysfunctional activation of brain mechanisms for sexual inhibition. A double-blind, randomized, placebo-controlled cross-over experiment was conducted on 129 women with FSIAD. The women received three different on-demand drug-combination treatments during 3 two-week periods: testosterone (0.5 mg) + sildenafil (50 mg), testosterone (0.5 mg) + buspirone (10 mg), or matching placebos. The resulted PPS were independently validated on patient-level and group-level. The AUC scores for T+S of the derivation set was 0.867 (95% CI = 0.796-0.939; p<0.001) and was 0.890 (95% CI = 0.778-1.000; p<0.001) on the validation set. For T+B the AUC of the derivation set was 0.957 (95% CI = 0.921-0.992; p<0.001) and 0.869 (95% CI = 0.746-0.992; p<0.001) for the validation set. Both formulas could reliably predict for each drug who benefit from the on-demand drugs and could therefore be useful in clinical practice., Competing Interests: The funder provided support in the form of salaries for authors DH, KvR, JB, and AT; shares / share options for authors KvR, JB, EC and AT. FM, PJ and EC declare no competing interests. JP is on the advisory board of, and/or a consultant to Emotional Brain, IVIX Corp. (Russia), Palatin Technologies/AMAG Pharmaceuticals (USA), and Viscunis Pharmaceuticals (Canada). The funder has active patents related to T+B, T+S, and the tablets: P72581, P75176, P79099-00, P92182, FID681336, P111330. This does not alter our adherence to PLOS ONE policies on sharing data and materials.
- Published
- 2021
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