Personal Pharmacogenomics for Patient Safety: Results From a Large Psychiatric Patient Cohort

<p xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" class="first" dir="auto" id="d18161869e98">Pharmacogenomics (PGx) holds promise to revolutionize modern healthcare. Although there are several prospective clinical studies in oncology and cardiology, demonstrating a beneficial effect of PGx-guided treatment in reducing adverse drug reactions, there are very few such studies in psychiatry, none of which spans across all main psychiatric indications, namely schizophrenia, major depressive disorder and bipolar disorder. In this study we aim to investigate the clinical effectiveness of PGx-guided treatment (occurrence of adverse drug reactions, hospitalisations and re-admissions, polypharmacy) and perform a cost analysis of the intervention. <p xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" dir="auto" id="d18161869e100">The findings from a multicenter, large-scale, prospective study of pre-emptive genome-guided treatment named as <b> <span style="text-decoration: underline">PRE</span> </b>emptive <b> <span style="text-decoration: underline">P</span> </b>harmacogenomic testing for preventing <b> <span style="text-decoration: underline">A</span> </b>dverse drug <b> <span style="text-decoration: underline">RE</span> </b>actions (PREPARE) in a large cohort of psychiatric patients (n=1163) suffering from schizophrenia, major depressive disorder and bipolar and anxiety disorders will be presented. <p xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" dir="auto" id="d18161869e126">In particular, patients with an actionable phenotype belonging to the PGx-guided arm present with 34.1% less adverse drug reactions compared to patients belonging to the control arm, 41.2% less hospitalisations and 40.5% less re-admissions and less duration of initial hospitalisations. Most importantly, we observed a 48.5% reduction of treatment costs in the PGx-guided arm with a reciprocal slight increase of the quality of life of patients suffering from major depressive disorder. Our data show that PGx-guided treatment can have a beneficial effect in psychiatric patients with a reciprocal reduction of treatment costs. Although some of these findings did not remain significant when all patients were considered, our data indicate that genome-guided psychiatric treatment may be successfully integrated in mainstream healthcare.