Rapport: Rutinebrug af CYP-test ved antipsykotisk behandling

Reference Design CYP2D6 alleles Population Antipsychotics Outcome measure OutcomeKohlrausch 2008(54)Panagiotidis 2007(47)Plesnicar 2006(38)Riedel 2005(55)CohortRetrospectiveLongitudinal(12-24 weeks)CohortProspectiveCross sectionalCohortProspectiveCross sectionalCohortProspectiveLongitudinal(6 weeks)*2, …,*6, *9, *10, *15,*17,*35,*40,*41duplications*3, *4, *5duplication*2, …,*6, *8,* …,*12,*14,*15N=183Caucasian(7 PMs, 15 IMs, 152 EMs, 9UMs)N=26Ethnicity NR, assumedCaucasian (Sweden)Schizophrenia andschizoaffective disorder(DSM-IV)Outpatients(1 PM, 8 IMs, 16 EMs and 1UM)N=131CaucasiansSchizophrenia or schizoaffectivedisorder (DSM-IV)Outpatients(6 PMs, 125 non PMs)*4, *6, *14 N=51Ethnicity not reported,assumed Caucasian(Germanychizophrenia (DSM-IV)(45 EMs, 6 IMs, 0 PMs)Any FGA(mostly haloperidoland chlorpromazine)Haloperidol decanoate(maintance monotherapy)Haloperidol,zuclopenthixol,fluphenazine orrisperidon(maintenancetherapy)Efficacy: Treatment-refractoryADRs: EPS (ESRS)Efficacy (PANNS)Kinetics: Peak and troughSS-conc.Efficacy: (PANNS)ADRs: EPS (Parkinsonism(SAS)), (TD (AIMS)),(akathisia (BAS))Risperidon Efficacy: Treatmentresponse, e.g. improve>30% (PANNS)Kinetics: Plasma conc., MRPM vs. EM: NS: OR = 0.73 [95% CI: 0.14,3.87][C]ADRs: EM vs. IM: EPS: NS (p=0.24)PANNS: EM vs. IM: NS: (p=0.63)Excluded from meta-analysis: Continuousdata.Efficacy: PM vs. EM/IM/UM: NSEPS: PM vs. EM/IM/UM: NS: OR =1.19[95% CI: 0.21, 6.78] [C]Efficacy: IMs vs. EMs: NSKinetics: IMs vs. EMs: NSExcluded from meta-analysis: Continuousdata.ADRs = Adverse drug reactions AIMS = abnormal involuntary movement scale BAS= Barnes akathisia scaleBPRS=Brief Psychiatric Rating Scale [C]=Calculated by reviewer (GJ) using Review Manager 51, CGI= Clinical Global Impression ScaleDIESS = Drug induced extrapyramidal symptom Score EM=Extensive metabolizer EPS= Extra pyramidale side effectsESRS= Extra pyramidale symptoms rating scale FGA=First Ggneration antipsycotics GAS = Global Assessment ScaleIM=Intermediate metabolizer NS=Non significant NR=Not reportedMR=Metabolic Ratio PANNS=Positive and negative syndrome scale PM = Poor metabolizerSADS= Schedule for affective Disorders and Schizophrenia TD = Tardive dyskinesia TDRS=Tardive dyskinesia rating scale[S]=Stated in manuscript SAS=Simpson and Angus SS=steady stateUM= Ultra rapid metabolizer1 Review Manager (RevMan) [Computer program]. Version 5.1. Copenhagen: The Nordic Cochrane Centre, The Cochrane Collaboration, 2011.110 Rutinebrug af CYP-test ved antipsykotisk behandling