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. 2024 Jul 11:15:1276410.
doi: 10.3389/fpsyt.2024.1276410. eCollection 2024.

Efficacy and safety of pharmacogenomic-guided antidepressant prescribing in patients with depression: an umbrella review and updated meta-analysis

Kiflu G Tesfamicael  1   2 , Lijun Zhao  2   3 , Rubén Fernández-Rodríguez  4 , David L Adelson  1 , Michael Musker  5 , Thomas M Polasek  6 , Martin David Lewis  1   2
Affiliations

Efficacy and safety of pharmacogenomic-guided antidepressant prescribing in patients with depression: an umbrella review and updated meta-analysis

Kiflu G Tesfamicael et al. Front Psychiatry. .

Abstract

Aim: To determine the efficacy and safety of pharmacogenomics (PGx)-guided antidepressant prescribing in patients with depression through an umbrella review and updated meta-analysis.

Methods: A comprehensive systematic search was conducted on PsycINFO, PubMed, Embase and the Cochrane databases. The pooled effect sizes of randomized controlled trials (RCTs) were expressed as mean differences for continuous data and risk ratios for noncontinuous data.

Results: Patients who received PGx-guided medications were 41% to 78% more likely to achieve remission and 20% to 49% more likely to respond to antidepressants than patients receiving treatment-as-usual (TAU).

Conclusion: PGx-guided antidepressant prescribing improves the treatment of depression. However, the significance and magnitude of the benefit varies widely between studies and different PGx testing panels.

Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42022321324.

Keywords: antidepressant; depression; genotyping panels; pharmacogenomics (PGx); pharmacogenomics-guided prescribing.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow diagram of the studies according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA).
Figure 2
Figure 2
Meta-analysis of the risk ratios/odd ratios on the systematic reviews included in the umbrella review for the effect of pharmacogenomics (PGx)-guided medication vs. the treatment as usual (TAU) for (A) remission rate and (B) response rate. Effect sizes are expressed as RR (risk ratio) or OR (odd ratio). JBI-QS indicates critical appraisal score using the JBI tool; Green=9-11, yellow=5-8 and Red≤4.
Figure 3
Figure 3
Meta-analysis of the risk ratios/odd ratios on the RCTs (randomised controlled trials) included in the updated meta-analysis for the effect of pharmacogenomics (PGx)-guided medications versus treatment as usual (TAU) for (A) mean differences in symptom improvement (B) Risk ratio for response (C) remission rates.
See this image and copyright information in PMC

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