期刊
CLINICAL PHARMACOLOGY & THERAPEUTICS
卷 110, 期 4, 页码 888-896出版社
WILEY
DOI: 10.1002/cpt.2149
关键词
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资金
- National Institutes of Health (NIH) [U24HG010135, R24 GM123930, U01 HG007269, UL1 TR001427, U01 HG010245, R01 DA042985, U01 HG8666, R35 GM124939, UL1 TR001082]
- National Health and Medical Research Council of Australia [1011251]
- Indiana University Grand Challenge Precision Health Initiative
- PharmGKB [U24HG010615]
Opioids are commonly used for the treatment of acute and chronic pain, and the clinical effects and adverse events are associated with genes such as CYP2D6, OPRM1, and COMT. While there is extensive research on the association between CYP2D6 and codeine/tramadol, data for hydrocodone, oxycodone, methadone, OPRM1, and COMT are more limited.
Opioids are mainly used to treat both acute and chronic pain. Several opioids are metabolized to some extent by CYP2D6 (codeine, tramadol, hydrocodone, oxycodone, and methadone). Polymorphisms in CYP2D6 have been studied for an association with the clinical effect and safety of these drugs. Other genes that have been studied for their association with opioid clinical effect or adverse events include OPRM1 (mu receptor) and COMT (catechol-O-methyltransferase). This guideline updates and expands the 2014 Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline for CYP2D6 genotype and codeine therapy and includes a summation of the evidence describing the impact of CYP2D6, OPRM1, and COMT on opioid analgesia and adverse events. We provide therapeutic recommendations for the use of CYP2D6 genotype results for prescribing codeine and tramadol and describe the limited and/or weak data for CYP2D6 and hydrocodone, oxycodone, and methadone, and for OPRM1 and COMT for clinical use.
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