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Pharmacogenetic testing for the guidance of psychiatric treatment: a multicenter retrospective analysis

Published online by Cambridge University Press:  21 April 2016

Jordi Espadaler Open the ORCID record for Jordi Espadaler [Opens in a new window] ,
Miquel Tuson ,
Jose Miguel Lopez-Ibor ,
Franciso Lopez-Ibor  and
Maria Ines Lopez-Ibor
Jordi Espadaler*
Affiliation:
Innovation Department, AB-Biotics SA, Barcelona, Spain
Miquel Tuson
Affiliation:
Innovation Department, AB-Biotics SA, Barcelona, Spain
Jose Miguel Lopez-Ibor
Affiliation:
Center Dr. Lopez-Ibor SA, Madrid, Spain
Franciso Lopez-Ibor
Affiliation:
Quibor SL, Madrid, Spain
Maria Ines Lopez-Ibor
Affiliation:
Department of Psychiatry, College of Medicine, Complutense University of Madrid, Madrid, Spain Institute of Neurological Investigations Lopez-Ibor, Madrid, Spain
*
*Address for correspondence: Jordi Espadaler, PhD, AB-BIOTICS S.A., Eureka Building, Autonomous University of Barcelona Bellaterra, Barcelona 08193, Spain. (Email: espadaler@ab-biotics.com)
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Abstract

Objective

We investigated the association between clinical outcome and the recommendations of a pharmacogenetic test (Neuropharmagen) in patients with a variety of psychiatric conditions whose previous treatment regimen had failed.

Methods

This retrospective, naturalistic, multicenter study included adult psychiatric patients (depression, psychosis, anxiety, bipolar, etc.) who had been seen at 3 private clinics. All patients had received pharmacogenetic testing (Neuropharmagen) and were classified depending on whether or not their post-test treatment regimen followed the test recommendations. Clinical severity was assessed with the Clinical Global Impression of Severity (CGI-S) at baseline (pre-test) and 3-month follow-up, and adverse events were recorded.

Results

182 patients were available for analysis. After multivariate adjustment, patients whose treatment followed the test recommendations had odds of improvement about 4 times greater than patients whose treatment did not follow the recommendations (adjusted OR=3.86, 95%CI 1.36–10.95; p=0.011). Importantly, psychiatric diagnosis did not significantly affect the odds of improvement. Also, in the subpopulation with baseline CGI-S score >3 (N=170), the rate of stabilization at follow-up (defined as CGI-S≤3) was significantly higher in patients whose treatment followed the pharmacogenetic recommendations (p=0.033). There was no apparent difference in the incidence of adverse events (6 patients in each group).

Conclusions

Non–drug naïve patients whose treatment followed the recommendations of pharmacogenetic testing were more likely to improve their condition than patients whose treatment did not. These results are consistent with previous clinical research on depressed patients, and this study also suggests that this benefit can be extended to psychiatric conditions other than depression.

Keywords

anxietybipolar disorderdepressiongenomicspersonalized medicinepharmacogeneticspsychiatric treatmentpsychotic disorder
Type
Original Research
Information
CNS Spectrums , Volume 22 , Issue 4 , August 2017 , pp. 315 - 324
Copyright
© Cambridge University Press 2016 

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Footnotes

We would like to thank Ariana Salavert, PhD (AB-Biotics SA), for help in preparing the study protocol; ADKNOMA Health Research SL (Barcelona, Spain), for providing contract research organization services; and Michael Hanna, PhD (Mercury Medical Research & Writing), for providing medical writing services.

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