Affiliation:
1. 2nd Department of Anaesthesiology, Faculty of Medicine, National, Kapodistrian University of Athens, Pain Management Unit, “Attikon” Hospital, Athens, Greece
2. Department of Anaesthesiology, General Hospital of Nikea, “Ag. Panteleimon,” Piraeus, Greece
3. Laboratory of Biology, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece
Abstract
AbstractObjectiveTo assess CYP2D6 genotype prevalence in chronic pain patients treated with tramadol or codeine.DesignProspective cohort study.SettingGeneral hospital, pain management unit.SubjectsPatients with chronic pain, treated with codeine or tramadol.MethodsPatients’ pain was assessed at baseline (numeric rating scale [NRS]; 0–10). Prescription of codeine or tramadol was selected randomly. The assessment of patients’ response to the drug in terms of pain relief and adverse effects was performed after 24 hours. Reduction of pain intensity of >50% or an NRS <4 was considered a positive response. Patients’ blood samples were collected during the first visit. Genotyping for the common variants CYP2D6 *2, *3, *4, *5, *6, *9, *10, *14, and *17 was performed, and alleles not carrying any polymorphic allele were classified as CYP2D6*1 (wild-type [wt]).ResultsSeventy-six consecutive patients were studied (20 males, 56 females), aged 21–85 years. Thirty-four received tramadol and 42 codeine. The main genotypes of CYP2D6 identified were the wt/wt (35.5%), the *4/wt (17.1%), and the *6/wt (10.5%). Adverse effects were common, especially in carriers of *9/*9, *5/*5, *5/*4, and *10/*10, as well as in variants including the 4 allele (*4/*1 [38.4%] and *4/*4 [42.8%]).ConclusionsGenotyping can facilitate personalized pain management with opioids, as specific alleles are related to decreased efficacy and adverse effects.
Publisher
Oxford University Press (OUP)
Subject
Anesthesiology and Pain Medicine,Neurology (clinical),General Medicine
Cited by
5 articles.
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