8 Referencer1. Lieberman JA, Stroup TS, McEvoy JP, Swartz MS, Rosenheck RA, Perkins DO, etal. Effectiveness of antipsychotic drugs in patients with chronic schizophrenia. N EnglJ Med 2005 09/22;353(12):1209-1223.2. NIP. Det Nationale Indikatorprojekt, Skizofreni, Dokumentalistrapport, version2.03, juli 2011.3. Brosen K. Drug-metabolizing enzymes and therapeutic drug monitoring in psychiatry.Ther Drug Monit 1996 08;18(4):393-396.4. Kirchheiner J, Brosen K, Dahl ML, Gram LF, Kasper S, Roots I, et al. <strong>CYP</strong>2D6 and<strong>CYP</strong>2C19 genotype-based dose recommendations for antidepressants: a first steptowards subpopulation-specific dosages. Acta Psychiatr Scand 2001 09;104(3):173-192.5. Kirchheiner J, Henckel HB, Meineke I, Roots I, Brockmoller J. Impact of the<strong>CYP</strong>2D6 ultrarapid metabolizer genotype on mirtazapine pharmacokinetics andadverse events in healthy volunteers. J Clin Psychopharmacol 2004 12;24(6):647-652.6. Chen S, Chou WH, Blouin RA, Mao Z, Humphries LL, Meek QC, et al. The cytochromeP450 2D6 (<strong>CYP</strong>2D6) enzyme polymorphism: screening costs and influenceon clinical outcomes in psychiatry. Clin Pharmacol Ther 1996 11;60(5):522-534.7. de Leon J, Barnhill J, Rogers T, Boyle J, Chou WH, Wedlund PJ. Pilot study of thecytochrome P450-2D6 genotype in a psychiatric state hospital. Am J Psychiatry 199809;155(9):1278-1280.8. Vandel P, H<strong>af</strong>fen E, Vandel S, Bonin B, Nezelof S, Sechter D, et al. Drug extrapyramidalside effects. <strong>CYP</strong>2D6 genotypes and phenotypes. Eur J Clin Pharmacol 199911;55(0031-6970; 9):659-665.9. Rau T, Wohlleben G, Wuttke H, Thuerauf N, Lunkenheimer J, Lanczik M, et al.<strong>CYP</strong>2D6 genotype: impact on adverse effects and nonresponse during treatment withantidepressants-a pilot study. Clin Pharmacol Ther 2004;75(5):386-393.10. Laika B, Leucht S, Heres S, Steimer W. Intermediate metabolizer: increased sideeffects in psychoactive drug therapy. The key to cost-effectiveness of pretreatment<strong>CYP</strong>2D6 screening? Pharmacogenomics J 2009 May 19;9(6):395-403.11. Chou WH, Yan FX, de Leon J, Barnhill J, Rogers T, Cronin M, et al. Extension ofa pilot study: impact from the cytochrome P450 2D6 polymorphism on outcome andcosts associated with severe mental illness. J Clin Psychopharmacol 2000 04;20(2):246-251.12. Shastry B. Pharmacogenetics and the concept of individualized medicine. ThePharmacogenomics Journal 2006;6:16-21.13. Rothstein M.A. Pharmacogenomics: Social, Ethical and Clinical Dimensions.Hoboken, N.J.: John Wiley & Sons; 2003.88 <strong>Rutinebrug</strong> <strong>af</strong> <strong>CYP</strong>-<strong>test</strong> <strong>ved</strong> <strong>antipsykotisk</strong> <strong>behandling</strong>
14. Hedgecoe A. The Politics of Personalised Medicine: Pharmacogenetics in theClinic. Cambridge: Cambridge University Press; 2004.15. Sct. Hans Hospital. Instruks <strong>ved</strong>rørende Genetisk analyse <strong>af</strong> cytokrom P450 i kliniskpsykiatri. Den Lokale Lægemidelkomite, 1. januar 2006. København: H:S; 2006.16. De Sundhedsfaglige Råd i Psykiatri i Københavns Amt og H:S. Behandling <strong>af</strong>patienter med debuterende psykose, med gentagne psykoser og med akutte psykotisketilstande, del 1. København: Københavns Amt & H:S; 2006.17. Blue Cross and Blue Shield Association,Technology Evaluation Center. SpecialReport: Genotyping for Cytocrome P450 Polymorfisms to Determine DrugMetabolizer Status. Chicago, Ill.: Blue Cross Blue Shield Association; 2004.18. Fleeman N, McLeod C, Bagust A, Beale S, Boland A, Dundar Y, et al. The clinicaleffectiveness and cost-effectiveness of <strong>test</strong>ing for cytochrome P450 polymorphisms inpatients with schizophrenia treated with antipsychotics: a systematic review and economicevaluation. Health Technol Assess 2010 Jan;14(3):1-157, iii.19. Jurgens G, Jacobsen CB, Rasmussen HB, Werge T, Nordentoft M, Andersen SE.Utility and adoption of <strong>CYP</strong>2D6 and <strong>CYP</strong>2C19 genotyping and its translation intopsychiatric clinical practice. Acta Psychiatr Scand 2012 Mar;125(3):228-237.20. Jurgens G, Rasmussen HB, Werge T, Dalhoff K, Nordentoft M, Andersen SE.Does the medication pattern reflect the <strong>CYP</strong>2D6 genotype in patients with diagnoseswithin the schizophrenic spectrum? J Clin Psychopharmacol 2012 Feb;32(1):100-105.21. Jurgens G, Rasmussen HB, Werge T, Dalhoff K, Nordentoft M, Andersen SE.Impact of Cytochrome P450 2D6 genotyping on the prescription of antipsychoticdrugs in patients diagnosed within the schizophrenic spectrum. A retrospective longitudinalstudy. Unpublished Unpublished.22. van der WJ, Steijns LS. Cytochrome P450 enzyme system: genetic polymorphismsand impact on clinical pharmacology. Ann Clin Biochem 1999 11;36 ( Pt 6):722-729.23. Burke W, Atkins D, Gwinn M, Guttmacher A, Haddow J, Lau J, et al. Genetic<strong>test</strong> evaluation: information needs of clinicians, policy makers, and the public. Am JEpidemiol 2002 Aug 15;156(4):311-318.24. Andreassen OA, MacEwan T, Gulbrandsen AK, McCreadie RG, Steen VM. Nonfunctional<strong>CYP</strong>2D6 alleles and risk for neuroleptic-induced movement disorders inschizophrenic patients. Psychopharmacology (Berl) 1997 05;131(2):174-179.25. Armstrong M, Daly AK, Blennerhassett R, Ferrier N, Idle JR. Antipsychotic druginducedmovement disorders in schizophrenics in relation to <strong>CYP</strong>2D6 genotype. Br JPsychiatry 1997 01;170:23-26.26. Brockmoller J, Kirchheiner J, Schmider J, Walter S, Sachse C, Muller-Oerlinghausen B, et al. The impact of the <strong>CYP</strong>2D6 polymorphism on haloperidolpharmacokinetics and on the outcome of haloperidol treatment. Clin Pharmacol Ther2002 10;72(4):438-452.89 <strong>Rutinebrug</strong> <strong>af</strong> <strong>CYP</strong>-<strong>test</strong> <strong>ved</strong> <strong>antipsykotisk</strong> <strong>behandling</strong>
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Rutinebrug af CYP-test vedantipsyko
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IndholdHvad er Medicinsk Teknologiv
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Hvad er Medicinsk Teknologivurderin
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TeknologiCYP-testen er en gentest.
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Samlet påviser dette studie, at en
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sættelse. Dette skyldes den store
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SummaryIntroductionA large part of
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• Are CYP2D6 and/or CYP2C19 geno
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The costs of pharmacy-dispensed dru
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Sundhedsstyrelsen vil gerne takke p
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1 Introduktion1.1 BaggrundDen medik
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faktor for testens anvendelighed. S
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lægens ordination af såvel antips
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NomenklaturCYP-enzymerne inddeles i
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I det følgende præsenteres egne s
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Figur 2 Studiepopulationerne i stud
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Bilag 10 Søgestrategi for den Sund
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Bilag 12 Resultaterne fra den blind
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Bilag 13 Variable i den økonomiske
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Bilag 15 Studiepopulation i den øk
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IndholdsfortegnelseSide 2:Side 3:Si
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Hvem anvender undersøgelsen:Rekvir
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Samtlige genotyper:CYP2D6Genotype A
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CYP 2D6 vejledninger:Tabel 1. Hurti
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Bilag 17 APPENDIKS til instruks ved
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(19-hydroxy-risperidon).Det må for
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CYP 2C19 analyseTabel 4. CYP 2C19-a
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Tabel 5. CYP 2C19-tilpasset doserin