Dutch Pharmacogenetics Working Group (DPWG) guideline for the gene-drug interaction between CYP2C19 and CYP2D6 and SSRIs

The Dutch Pharmacogenetics Working Group (DPWG) guideline presented here, presents the gene-drug interaction between the genes CYP2C19 and CYP2D6 and antidepressants of the selective serotonin reuptake inhibitor type (SSRIs). Both genes' genotypes are translated into predicted normal metabolizer (NM), intermediate metabolizer (IM), poor metabolizer (PM), or ultra-rapid metabolizer (UM). Evidence-based dose recommendations were obtained, based on a structured analysis of published literature. In CYP2C19 PM patients, escitalopram dose should not exceed 50% of the normal maximum dose. In CYP2C19... Mehr ...

Verfasser: Brouwer, Jurriaan M. J. L.
Nijenhuis, Marga
Soree, Bianca
Guchelaar, Henk-Jan
Swen, Jesse J.
van Schaik, Ron H. N.
van der Weide, Jan
Rongen, Gerard A. P. J. M.
Buunk, Anne-Marie
De Boer-Veger, Nienke J.
Houwink, Elisa J. F.
van Westrhenen, Roos
Wilffert, Bob
Deneer, Vera H. M.
Mulder, Hans
Dokumenttyp: Artikel
Erscheinungsdatum: 2022
Reihe/Periodikum: Brouwer , J M J L , Nijenhuis , M , Soree , B , Guchelaar , H-J , Swen , J J , van Schaik , R H N , van der Weide , J , Rongen , G A P J M , Buunk , A-M , De Boer-Veger , N J , Houwink , E J F , van Westrhenen , R , Wilffert , B , Deneer , V H M & Mulder , H 2022 , ' Dutch Pharmacogenetics Working Group (DPWG) guideline for the gene-drug interaction between CYP2C19 and CYP2D6 and SSRIs ' , European Journal of Human Genetics , vol. 30 , pp. 1114–1120 . https://doi.org/10.1038/s41431-021-01004-7
Schlagwörter: IMPLEMENTATION CONSORTIUM / CYP2C19-ASTERISK-17 ALLELE / GENOTYPE / INHIBITORS / FLUOXETINE / PAROXETINE / SERTRALINE / VARIANT / BENCH
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-27058028
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : https://hdl.handle.net/11370/1174231d-6429-4d40-994c-7aa5e4455926

The Dutch Pharmacogenetics Working Group (DPWG) guideline presented here, presents the gene-drug interaction between the genes CYP2C19 and CYP2D6 and antidepressants of the selective serotonin reuptake inhibitor type (SSRIs). Both genes' genotypes are translated into predicted normal metabolizer (NM), intermediate metabolizer (IM), poor metabolizer (PM), or ultra-rapid metabolizer (UM). Evidence-based dose recommendations were obtained, based on a structured analysis of published literature. In CYP2C19 PM patients, escitalopram dose should not exceed 50% of the normal maximum dose. In CYP2C19 IM patients, this is 75% of the normal maximum dose. Escitalopram should be avoided in UM patients. In CYP2C19 PM patients, citalopram dose should not exceed 50% of the normal maximum dose. In CYP2C19 IM patients, this is 70% (65-75%) of the normal maximum dose. In contrast to escitalopram, no action is needed for CYP2C19 UM patients. In CYP2C19 PM patients, sertraline dose should not exceed 37.5% of the normal maximum dose. No action is needed for CYP2C19 IM and UM patients. In CYP2D6 UM patients, paroxetine should be avoided. No action is needed for CYP2D6 PM and IM patients. In addition, no action is needed for the other gene-drug combinations. Clinical effects (increase in adverse events or decrease in efficacy) were lacking for these other gene-drug combinations. DPWG classifies CYP2C19 genotyping before the start of escitalopram, citalopram, and sertraline, and CYP2D6 genotyping before the start of paroxetine as "potentially beneficial" for toxicity/effectivity predictions. This indicates that genotyping prior to treatment can be considered on an individual patient basis.