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药物基因检测对难治性精神分裂症患者氯氮平治疗疗效的影响

Impact of Pharmacogenetic Testing on Clozapine Treatment Efficacy in Patients with Treatment-Resistant Schizophrenia.

作者信息

Sangüesa Estela, Fernández-Egea Emilio, Concha Julia, García Cristina B, Ribate María Pilar

机构信息

Facultad de Ciencias de la Salud, Universidad San Jorge, Villanueva de Gállego, E-50830 Zaragoza, Spain.

Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge CB21 5EF, UK.

出版信息

Biomedicines. 2024 Mar 7;12(3):597. doi: 10.3390/biomedicines12030597.

Abstract

Managing schizophrenia with clozapine poses a significant challenge due to prevalent therapeutic failures. The increasing interest in personalized medicine underscores the importance of integrating pharmacogenetic information for effective pharmacotherapeutic monitoring in patients. The objective of this study was to explore the correlation between , , , , and polymorphisms and clozapine response in 100 patients with Treatment-Resistant Schizophrenia. Different scales such as the Positive and Negative Syndrome Scale (PANSS), the Warwick-Edinburgh Mental Wellbeing Scale (SWEMWBS), the Global Assessment of Functioning Scale (GAF), the Brief Negative Symptom Scale (BNSS), and pharmacokinetic parameters were used to analyse the efficacy of the treatment. Patients who exclusively responded to clozapine compared to the patients with augmentation strategies exhibited distinctive features, such as lower doses, plasma levels, and presented less-pronounced symptomatology. Genetic associations were explored, highlighting , and the *1F/*1F polymorphism for the gene.

摘要

由于普遍存在治疗失败的情况,使用氯氮平治疗精神分裂症面临重大挑战。对个性化医疗的兴趣日益浓厚,凸显了整合药物遗传学信息以对患者进行有效药物治疗监测的重要性。本研究的目的是探讨100例难治性精神分裂症患者中,[此处原文缺失具体基因名称]、[此处原文缺失具体基因名称]、[此处原文缺失具体基因名称]、[此处原文缺失具体基因名称]和[此处原文缺失具体基因名称]多态性与氯氮平反应之间的相关性。使用不同量表,如阳性和阴性症状量表(PANSS)、沃里克 - 爱丁堡心理健康量表(SWEMWBS)、功能总体评定量表(GAF)、简明阴性症状量表(BNSS)以及药代动力学参数来分析治疗效果。与采用增效策略的患者相比,仅对氯氮平有反应的患者表现出独特特征,如较低剂量、血浆水平,且症状表现不那么明显。研究了基因关联,突出了[此处原文缺失具体基因名称]以及[此处原文缺失具体基因名称]基因的*1F/*1F多态性。

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