Efficacy and safety of pharmacogenomic-guided antidepressant prescribing in patients with depression: an umbrella review and updated meta-analysis

Kiflu G Tesfamicael; Lijun Zhao; Rubén Fernández-Rodríguez; David L Adelson; Michael Musker; Thomas M Polasek; Martin David Lewis

doi:10.3389/fpsyt.2024.1276410

Efficacy and safety of pharmacogenomic-guided antidepressant prescribing in patients with depression: an umbrella review and updated meta-analysis

Front Psychiatry. 2024 Jul 11:15:1276410. doi: 10.3389/fpsyt.2024.1276410. eCollection 2024.

Authors

Kiflu G Tesfamicael^{1

2}, Lijun Zhao^{2

3}, Rubén Fernández-Rodríguez⁴, David L Adelson¹, Michael Musker⁵, Thomas M Polasek⁶, Martin David Lewis^{1

2}

Affiliations

¹ School of Biological Sciences, University of Adelaide, Adelaide, SA, Australia.
² Lifelong Health, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia.
³ Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia.
⁴ Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain.
⁵ Adelaide Nursing School, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia.
⁶ Centre for Medicine Use and Safety, Monash University, Melbourne, VIC, Australia.

Abstract

Aim: To determine the efficacy and safety of pharmacogenomics (PGx)-guided antidepressant prescribing in patients with depression through an umbrella review and updated meta-analysis.

Methods: A comprehensive systematic search was conducted on PsycINFO, PubMed, Embase and the Cochrane databases. The pooled effect sizes of randomized controlled trials (RCTs) were expressed as mean differences for continuous data and risk ratios for noncontinuous data.

Results: Patients who received PGx-guided medications were 41% to 78% more likely to achieve remission and 20% to 49% more likely to respond to antidepressants than patients receiving treatment-as-usual (TAU).

Conclusion: PGx-guided antidepressant prescribing improves the treatment of depression. However, the significance and magnitude of the benefit varies widely between studies and different PGx testing panels.

Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42022321324.

Keywords: antidepressant; depression; genotyping panels; pharmacogenomics (PGx); pharmacogenomics-guided prescribing.

Publication types

Systematic Review

Grants and funding

The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. Breakthrough Mental Health Research Foundation. Breakthrough is Australia’s only dedicated mental health research foundation. They exist to support groundbreaking research that will help to transform the lives of those affected by mental health issues. Their goal is to fund evidence-based research to better understand what causes mental illness, how to reduce its impact and ultimately prevent mental illness from happening in the first place.