Effectiveness of pharmacogenomic tests including CYP2D6 and CYP2C19 genomic variants for guiding the treatment of depressive disorders: Systematic review and meta-analysis of randomised controlled trials

Danilo Arnone*, Omar Omar, Teresa Arora, Linda Östlundh, Reshma Ramaraj, Syed Javaid, Romona Devi Govender, Bassam R. Ali, George P. Patrinos, Allan H. Young, Emmanuel Stip

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

9 Citations (Scopus)
14 Downloads (Pure)

Abstract

Major depressive disorders are prevalent conditions with limited treatment response and remission. Pharmacogenomics tests including CYP2D6 and CYP2C19 genomic variants provide the most reliable actionable approach to guide choice and dosing of antidepressants in major depression to improve outcomes. We carried out a meta-analysis and meta-regression analyses of randomised controlled trials evaluating pharmacogenomic tests with CYP2D6 and CYP2C19 polymorphisms in major depression. A systematic review was conducted according to PRISMA and Cochrane guidelines to search several electronic databases. Logarithmically transformed odds ratios (OR) and confidence intervals (CI) for improvement, response and remission were calculated. A random-effects meta-analysis and meta-regression analyses were subsequently carried out. Twelve randomised controlled trials were included. Pharmacogenomic tests in the treatment of depression were more effective than treatment as usual for improvement (OR:1.63, CI: 1.19–2.24), response (OR: 1.46; CI: 1.16–1.85) and remission (OR: 1.85; CI: 1.23–2.76) with no evidence of publication bias. Remission was less favourable in recent studies. The results are promising but cautious use of pharmacogenomics in major depression is advisable. PROSPERO registration ID: CRD42021261143.

Original languageEnglish
Article number104965
JournalNeuroscience and Biobehavioral Reviews
Volume144
DOIs
Publication statusPublished - Jan 2023

Keywords

  • CYP2C19
  • CYP2D6
  • CYP450
  • Depressive disorders
  • Major depression
  • Mood disorders
  • Pharmacogenetics
  • Pharmacogenomics

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