Care Guided by Pharmacogenomic Testing May Benefit Patients With Possible Gene-Drug Interactions

SAN DIEGO—Combinatorial pharmacogenomic testing offers clinical utility for patients with major depressive disorder who have failed to respond to medication for genetic reasons, according to a study presented during poster sessions at Psych Congress 2019.

“The GUIDED trial demonstrated that combinatorial pharmacogenomic testing significantly improved the rate of response and remission and approached significance for symptom improvement. However, these findings may have been diluted by the inclusion of patients taking medications with no predicted gene-drug interactions,” researchers wrote in the study introduction. “Here, we examined outcomes only in patients who entered the study taking medications with predicted gene-drug interactions.”

The study randomized 786 patients with major depressive disorder who did not improve with psychotropic medication to 1 of 2 arms: treatment as usual or care guided by results from combinatorial pharmacogenetic testing. At baseline, all patients in the analysis were taking medications predicted to have gene-drug interactions. Patients and raters were blinded through week 8.

At week 8, patients receiving care guided by pharmacogenomic testing had significantly better outcomes compared with patients who received treatment as usual.

Also from Psych Congress: Esketamine Quickly Reduces Depressive Symptoms in Patients at Risk of Suicide

According to the study, 27% of patients in the guided-care arm achieved treatment response, and 18.2% of them achieved remission. On average, scores on the 17-item Hamilton Depression Rating Scale (HAM-D17) improved 27.1% in the guided-care arm.

In comparison, 19% of patients in the treatment-as-usual arm achieved treatment response, and 10.7% of them achieved remission. Scores on the HAM-D17 improved an average 22.1% in the treatment-as-usual arm.

“Combinatorial pharmacogenetic testing,” researchers concluded, “significantly improves outcomes among patients with major depressive disorder who are failing medications for likely pharmacogenomic reasons.”

Assurex Health Inc. sponsored the study.

—Jolynn Tumolo

Reference

Depatie J, Thase M, Parikh S, et al. Combinatorial pharmacogenomic testing improves outcomes for patients taking medications with gene-drug interactions in a randomized, controlled trial. Poster presented at Psych Congress 2019: October 3-6, 2019; San Diego, CA. Poster 125.