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CYP2D6 genotype and reduced codeine analgesic effect in real-world clinical practice
- Source :
- The pharmacogenomics journal
- Publication Year :
- 2021
- Publisher :
- Springer Science and Business Media LLC, 2021.
-
Abstract
- Cytochrome P450 2D6 (CYP2D6) O-demethylates codeine to the active drug, morphine. However, the utility of testing for CYP2D6 metabolizer status in patients receiving codeine in real-world clinical practice is poorly defined. Using data from a DNA bank linked to de-identified electronic health records, we studied 157 patients with a baseline pain score higher than 4 (0-10 scale) who received codeine. Based on CYP2D6 genotyping, 69 were classified as poor/intermediate and 88 as normal/ultrarapid CYP2D6 metabolizers. Pain response was defined as a score of 4 or lower while receiving codeine. In a propensity-score adjusted model, poor/intermediate metabolizers had lower odds (OR = 0.35, p = 0.02) of achieving a pain response than normal/ultrarapid metabolizers. To discriminate between codeine responders and nonresponders, a score including CYP2D6 phenotype and clinical variables was built. The response rate was 38.5% among patients in the high, 17.3% in the intermediate, and 9.4% in the low-score groups, respectively (p = 0.001).
- Subjects :
- Male
0301 basic medicine
Analgesic effect
medicine.medical_specialty
CYP2D6
Genotype
030226 pharmacology & pharmacy
Article
03 medical and health sciences
0302 clinical medicine
Internal medicine
Genetics
Humans
Medicine
In patient
Aged
Pharmacology
Response rate (survey)
Polymorphism, Genetic
Morphine
Codeine
business.industry
Middle Aged
Analgesics, Opioid
Clinical Practice
Phenotype
030104 developmental biology
Cytochrome P-450 CYP2D6
Molecular Medicine
Female
business
medicine.drug
Subjects
Details
- ISSN :
- 14731150 and 1470269X
- Volume :
- 21
- Database :
- OpenAIRE
- Journal :
- The Pharmacogenomics Journal
- Accession number :
- edsair.doi.dedup.....7ffcd5947d2f2743aa85e86c088aeb1c