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Delage, Clément; Darnaud, Léa; Etain, Bruno; Vignes, Marina; Ly, Tu-Ky; Frapsauce, Alexia; Veyrier, Marc; Delavest, Marine; Marlinge, Emeline; Hennion, Vincent; Meyrel, Manon; Jacob, Aude; Chouchana, Margot; Smati, Julie; Pataud, Guillaume; Khoudour, Nihel; Fontan, Jean-Eudes; Labat, Laurence; Bellivier, Frank; Lloret-Linares, Célia; Declèves, Xavier; Bloch, Vanessa

Cytochromes P450 and P-Glycoprotein Phenotypic Assessment to Optimize Psychotropic Pharmacotherapy: A Retrospective Analysis of Four Years of Practice in Psychiatry

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  • Medientyp: E-Artikel
  • Titel: Cytochromes P450 and P-Glycoprotein Phenotypic Assessment to Optimize Psychotropic Pharmacotherapy: A Retrospective Analysis of Four Years of Practice in Psychiatry
  • Beteiligte: Delage, Clément; Darnaud, Léa; Etain, Bruno; Vignes, Marina; Ly, Tu-Ky; Frapsauce, Alexia; Veyrier, Marc; Delavest, Marine; Marlinge, Emeline; Hennion, Vincent; Meyrel, Manon; Jacob, Aude; Chouchana, Margot; Smati, Julie; Pataud, Guillaume; Khoudour, Nihel; Fontan, Jean-Eudes; Labat, Laurence; Bellivier, Frank; Lloret-Linares, Célia; Declèves, Xavier; Bloch, Vanessa
  • Erschienen: MDPI AG, 2022
  • Erschienen in: Journal of Personalized Medicine
  • Sprache: Englisch
  • DOI: 10.3390/jpm12111869
  • ISSN: 2075-4426
  • Schlagwörter: Medicine (miscellaneous)
  • Entstehung:
  • Anmerkungen:
  • Beschreibung: <jats:p>Altered cytochromes P450 enzymes (CYP) and P-glycoprotein transporter (P-gp) activity may explain variabilities in drug response. In this study, we analyzed four years of phenotypic assessments of CYP/P-gp activities to optimize pharmacotherapy in psychiatry. A low-dose probe cocktail was administered to evaluate CYP1A2, 2B6, 2D6, 2C9, 2C19, 3A4, and P-gp activities using the probe/metabolite concentration ratio in blood or the AUC. A therapeutic adjustment was suggested depending on the phenotyping results. From January 2017 to June 2021, we performed 32 phenotypings, 10 for adverse drug reaction, 6 for non-response, and 16 for both reasons. Depending on the CYP/P-gp evaluated, only 23% to 56% of patients had normal activity. Activity was decreased in up to 57% and increased in up to 60% of cases, depending on the CYP/P-gp evaluated. In 11/32 cases (34%), the therapeutic problem was attributable to the patient’s metabolic profile. In 10/32 cases (31%), phenotyping excluded the metabolic profile as the cause of the therapeutic problem. For all ten individuals for which we had follow-up information, phenotyping allowed us to clearly state or clearly exclude the metabolic profile as a possible cause of therapeutic failure. Among them, seven showed a clinical improvement after dosage adaptation, or drug or pharmacological class switching. Our study confirmed the interest of CYP and P-gp phenotyping for therapeutic optimization in psychiatry.</jats:p>
  • Zugangsstatus: Freier Zugang