Personalized therapy in pain management: where do we stand?

Stamer, Ulrike M; Zhang, Lan; Stüber, Frank (2010). Personalized therapy in pain management: where do we stand? Pharmacogenomics, 11(6), pp. 843-64. London: Future Medicine 10.2217/PGS.10.47

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Genomic variations influencing response to pharmacotherapy of pain are currently under investigation. Drug-metabolizing enzymes represent a major target of ongoing research in order to identify associations between an individual's drug response and genetic profile. Polymorphisms of the cytochrome P450 enzymes (CYP2D6) influence metabolism of codeine, tramadol, hydrocodone, oxycodone and tricyclic antidepressants. Blood concentrations of some NSAIDs depend on CYP2C9 and/or CYP2C8 activity. Genomic variants of these genes associate well with NSAIDs' side effect profile. Other candidate genes, such as those encoding (opioid) receptors, transporters and other molecules important for pharmacotherapy in pain management, are discussed; however, study results are often equivocal. Besides genetic variants, further variables, for example, age, disease, comorbidity, concomitant medication, organ function as well as patients' compliance, may have an impact on pharmacotherapy and need to be addressed when pain therapists prescribe medication. Although pharmacogenetics as a diagnostic tool has the potential to improve patient therapy, well-designed studies are needed to demonstrate superiority to conventional dosing regimes.

Item Type:

Journal Article (Further Contribution)

Division/Institute:

04 Faculty of Medicine > Department of Intensive Care, Emergency Medicine and Anaesthesiology (DINA) > Clinic and Policlinic for Anaesthesiology and Pain Therapy

UniBE Contributor:

Stamer, Ulrike and Stüber, Frank

ISSN:

1462-2416

Publisher:

Future Medicine

Language:

English

Submitter:

Jeannie Wurz

Date Deposited:

04 Oct 2013 14:08

Last Modified:

23 Jan 2018 12:17

Publisher DOI:

10.2217/PGS.10.47

PubMed ID:

20504256

Web of Science ID:

000278605900016

URI:

https://boris.unibe.ch/id/eprint/647 (FactScience: 200043)

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