Clinical utility of combinatorial pharmacogenomic testing in depression: A Canadian patient- and rater-blinded, randomized, controlled trial

• DOI: 10.1038/s41398-022-01847-8
• Publication Date: 2022-03-14T14:04:56Z
• Authors: Arun K. Tiwari; Clement C. Zai; C. Anthony Altar; Julie-Anne Tanner; Paige E. Davies; Paul Traxler; James Li; Elizabeth S. Cogan; Matthew T. Kucera; Ana Gugila; Nicole Braganza; Heather Emmerson; Gwyneth Zai; Daniel J. Müller; Robert Levitan; Stefan Kloiber; Zafiris J. Daskal...; Benicio N. Frey; James M. Bowen; Jean-Eric Tarride; Richard Tytus; Ranjith Chandrasena; Nicholas Voudouris; Valerie H. Taylor; Raymond Tempier; Verinder Sharma; Akshya Vasudev; Peter Dzongowski; Lew Pliamm; Todd Greenspoon; Bryan M. Dechairo; James L. Kennedy
• Keywords: Depression; Pharmacogenomics

Abstract The pharmacological treatment of depression consists stages trial and error, with less than 40% patients achieving remission during first medication trial. However, in a large, randomized-controlled (RCT) the U.S. (“GUIDED”), significant improvements response rates were observed who received guided by combinatorial pharmacogenomic testing, compared to treatment-as-usual (TAU). Here we present results from Canadian “GAPP-MDD” RCT. This 52-week, 3-arm, multi-center, participant- rater-blinded RCT evaluated clinical outcomes among whose was testing TAU. primary outcome symptom improvement (change 17-item Hamilton Depression Rating Scale, HAM-D17) at week 8. Secondary included (≥50% decrease (HAM-D17 ≤ 7) Numerically, guided-care arm had greater (27.6% versus 22.7%), (30.3% (15.7% 8.3%) TAU, although these differences not statistically significant. Given that GAPP-MDD ultimately underpowered detect patient outcomes, it assessed parallel larger GUIDED We relative consistent between (33.0% response, 89.0% remission) (31.0% 51.0% trials. Together GUIDED, indicate can be an effective tool help guide context healthcare setting (ClinicalTrials.gov NCT02466477).