期刊
PHARMACOGENOMICS
卷 15, 期 13, 页码 1687-1700出版社
FUTURE MEDICINE LTD
DOI: 10.2217/PGS.14.121
关键词
alcohol; alcohol dependence; alcohol use disorder; naltrexone; opioid receptor; OPRM1; pharmacogenomics; polymorphism; systematic review
资金
- Agency for Healthcare Research and Quality, US Department of Health and Human Services [HH-SA290201200008I_HHSA29032002T]
- AHRQ
Aim: To assess whether response to medications for alcohol use disorders varies by genotype. Methods: Systematic review and meta-analysis. Results: We found no studies that assessed the clinical utility of genotype-guided dosing strategies or genotype-guided medication selection, and none randomized by genotype. All included studies assessed the association between genotype and response to medication. Of 15 included studies, eight (n = 1365 participants) assessed variation in naltrexone response and polymorphisms of OPRM1. Our meta-analyses for return to heavy drinking found no significant difference between A allele homozygotes and those with at least one G allele, both without (risk difference: 0.26; 95% CI: -0.01-0.53; n = 174) and with inclusion of studies rated as high or unclear risk of bias (risk difference: 0.14; 95% CI: -0.03-0.3; n = 382). For all other polymorphism-medication pairs, we found just one eligible study. Conclusion: Estimates of effect for return to heavy drinking suggest it is possible that patients with at least one G allele of A118G polymorphism of OPRM1 might be more likely to respond to naltrexone, but confidence intervals were wide; additional studies are needed to improve confidence in the estimates.
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