Rapport: Rutinebrug af CYP-test ved antipsykotisk behandling

Bilag 4 Skemaer over fundne studier til TeknologiOversigt over studier, der belyser sammenhængen mellem CYP2D6 polymorfisme og bivirkninger hos patienter i behandling medantipsykotika.Studier inkluderet i metaanalysen:Reference Design CYP2D6 alleles Population Antipsychotics Outcome measure OutcomeAndreassen1997(24)Armstrong1997(25)Brockmöller2002(26)Ellingrod (1)2002(27)Fu2006(28)Cohort1) Prospect. crosssect.2) Retrospect.longitudinal(2-14 years)CohortRetrospect.Longitudinal (durationNR)Cohort studyProspect.Bayesian approachLongitudinal (28 days)CohortProspect.Cross-sect.1) Cohort element2) Case controlelementProspect.Cross-sect.*3,*4,*5,*6,*7N=75CaucasianSchizophrenia(ICD-9)25 Cases (5PMs),50 Controls (3PMs)*3,*4, *5 N=76CaucasianSchizophrenia (DSM-IIIR)43 EMs, 28 IMs, 5 PMs*2, *3,*4, …,*15, *17duplicationsN=175Ethnicity NR, assumedCaucasian (Germany)Schizophrenia (N=114),schizoaffective psychosis(N=40), other diagnoses(N=21) (ICD-10).Inpatients106 EMs, 56 IMs, 2 UMs, 5PMs*3,*4 N=37Ethnicity NRSchizophrenia (DSM-IV)11 EMs, 26 IMs, 0 PMs*10 N=159AsiansSchizophrenia (DMS IV)82 Cases (15 CC, 30 CT, 37TT), 77 Controls (20 CC, 34CT, 23 TT)Any APD 1) ADRs: TD, Parkinson,Akathisia2) ADRs: TD1) NS (Stated)2) PM vs. EM: NS: OR =3.85 [95% CI:0.80, 18.53] [C],IM vs. EM: NS: OR = 0.95 [95% CI: 0.32,2.84] [C]NR ADRs: TD (AIMS) PM vs. EM: NS: OR = 5.56 [95% CI: 0.57,53.97] [C]IM vs. EM: NS: OR =1.20 [95% CI: 0.46,3.14] [C]Haloperidol(both decanoate andnon depot preparations)Any FGA(mostly haloperidol)ADRs: EPS scaleEfficacy : (PANNS)Kinetics: trough conc. onday 3, 14 and 28 afteradmission,modelled concentrationcurves based on BayesianapproachEPS: PM vs. EM: p=0.02: OR =21.67 [95%CI: 2.32, 202.34]No significant difference in changes inpsychotic symptoms (between day 14and 3) between genotype groups.ADRs: TD (AIMS) IM vs. EM: NS: OR = 3.14 [95% CI: 0.71,13.96] [C]Any FGA ADRs: TD (AIMS) 1) Cohort: IM vs. EM: NS: OR = 2.14 [95%CI: 0.92, 5.01] [C]2) Case-control: Association betweenTD and allele frequency ( p = 0.038) [S]104 Rutinebrug af CYP-test ved antipsykotisk behandling