IMEX   05356
INSTITUTO DE MEDICINA EXPERIMENTAL
Unidad Ejecutora - UE
congresos y reuniones científicas
Título:
PHARMACOGENETICS OF OPIOID ANALGESIA IN ARGENTINE PATIENTS WITH CHRONIC PAIN
Autor/es:
FONTANINI E; DE BRASI CD; FONTECHA MB; FUNDIA AF; ABELLEYRO MM; ANADÓN MR; SIVANTO MV
Lugar:
Roma
Reunión:
Congreso; 10th World Congress of the World Institute of Pain (WIP); 2020
Institución organizadora:
World Institute of Pain
Resumen:
Background: Chronic Pain (CP) is a complex disease affecting 22% of patients worldwide. Variability in response to opioid treatment and Adverse Drugs Reactions (ADR) could be influenced by genetic variations in drug metabolizing enzymes (CYP2D6) and transporters (ABCB1/MDR1).Aims: Evaluate the role of CYP2D6 and MDR1 genetics in response to opioid therapy.Methods: Genomic-DNA samples from 100 patients treated with Tramadol or Codeine (with or without an additional analgesic) were tested for variants in CYP2D6 (2549delA, 1846G>A and 1707delT) and MDR1 (3435C>T) by allele-specific PCR. Statistics involves Fisher Exact tests and Hazard Ratio (HR) with (95%CI). Treatment response was evaluated after 48 hours.Results: After treatment, patients exhibiting variants different from the CYP2D6 reference haplotype [AGT] showed a non-significant increase of the relative-risks for suffering pain (2.3,0.82-6.68,p=0.15, N=100). No important differences were found when MDR1 genotypes C/C were compared to T/_ (1.38,0.56-3.4,p=0.57,N=100). Tramadol showed a highly significant effect in relieving pain over Codeine regardless the patient?s CYP2D6 genotype (0.244,0.11-0.56,p=0.0087**,N=100) and (0.247,0.09-0.64,p=0.022*,N=91, for patients with CYP2D6 [AGT] haplotype. Tramadol or Codeine treatment combined with a second analgesic did not significantly improve the perceived pain outcome (0.71,0.28-1.79,p=0.55,N=100). Patients CYP2D6 [AGT] treated with Tramadol showed significantly less ADR than Codeine (0.22,0.08-0.59,p=0.016,N=91). Conclusions: Our Argentine series show minor or no influence of CYP2D6 and MDR1 variants on pain treatment. Tramadol treatment resulted superior to Codeine in all genetic backgrounds.