Scientific article
Meta-analysis
OA Policy
English

Metabolic activity of CYP2C19 and CYP2D6 on antidepressant response from 13 clinical studies using genotype imputation : a meta-analysis

Published inTranslational psychiatry, vol. 14, no. 1, 296
Errata
  • Erratum in : Li D, Pain O, Fabbri C, Wong WLE, Lo CWH, Ripke S, Cattaneo A, Souery D, Dernovsek MZ, Henigsberg N, Hauser J, Lewis G, Mors O, Perroud N, Rietschel M, Uher R, Maier W, Baune BT, Biernacka JM, Bondolfi G, Domschke K, Kato M, Liu YL, Serretti A, Tsai SJ, Weinshilboum R; GSRD Consortium, the Major Depressive Disorder Working Group of the Psychiatric Genomics Consortium; McIntosh AM, Lewis CM. Correction: Metabolic activity of CYP2C19 and CYP2D6 on antidepressant response from 13 clinical studies using genotype imputation: a meta-analysis. Transl Psychiatry. 2024 Aug 31;14(1):350.
  • DOI : 10.1038/s41398-024-03064-x
  • PMID : 39217139
Publication date2024-07-19
First online date2024-07-19
Abstract

Cytochrome P450 enzymes including CYP2C19 and CYP2D6 are important for antidepressant metabolism and polymorphisms of these genes have been determined to predict metabolite levels. Nonetheless, more evidence is needed to understand the impact of genetic variations on antidepressant response. In this study, individual clinical and genetic data from 13 studies of European and East Asian ancestry populations were collected. The antidepressant response was clinically assessed as remission and percentage improvement. Imputed genotype was used to translate genetic polymorphisms to metabolic phenotypes (poor, intermediate, normal, and rapid+ultrarapid) of CYP2C19 and CYP2D6. CYP2D6 structural variants cannot be imputed from genotype data, limiting the determination of metabolic phenotypes, and precluding testing for association with response. The association of CYP2C19 metabolic phenotypes with treatment response was examined using normal metabolizers as the reference. Among 5843 depression patients, a higher remission rate was found in CYP2C19 poor metabolizers compared to normal metabolizers at nominal significance but did not survive after multiple testing correction (OR = 1.46, 95% CI [1.03, 2.06], p = 0.033, heterogeneity I 2 = 0%, subgroup difference p = 0.72). No metabolic phenotype was associated with percentage improvement from baseline. After stratifying by antidepressants primarily metabolized by CYP2C19, no association was found between metabolic phenotypes and antidepressant response. Metabolic phenotypes showed differences in frequency, but not effect, between European- and East Asian-ancestry studies. In conclusion, metabolic phenotypes imputed from genetic variants using genotype were not associated with antidepressant response. CYP2C19 poor metabolizers could potentially contribute to antidepressant efficacy with more evidence needed. Sequencing and targeted pharmacogenetic testing, alongside information on side effects, antidepressant dosage, depression measures, and diverse ancestry studies, would more fully capture the influence of metabolic phenotypes.

Keywords
  • Antidepressive Agents / therapeutic use
  • Asian People / genetics
  • Cytochrome P-450 CYP2C19 / genetics
  • Cytochrome P-450 CYP2D6 / genetics
  • Cytochrome P-450 CYP2D6 / metabolism
  • Depressive Disorder, Major / drug therapy
  • Depressive Disorder, Major / genetics
  • Depressive Disorder, Major / metabolism
  • Female
  • Genotype
  • Humans
  • Male
  • Phenotype
  • Treatment Outcome
  • White People / genetics
Funding
  • NIMH NIH HHS - [U01 MH109528]
  • U.S. Department of Health & Human Services | NIH | National Institute of Mental Health - [MH124873]
  • Wellcome Trust - [226770/Z/22/Z]
  • NIGMS NIH HHS - [U19 GM061388]
Citation (ISO format)
LI, Danyang et al. Metabolic activity of CYP2C19 and CYP2D6 on antidepressant response from 13 clinical studies using genotype imputation : a meta-analysis. In: Translational psychiatry, 2024, vol. 14, n° 1, p. 296. doi: 10.1038/s41398-024-02981-1
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Article (Published version)
Updates (1)
Erratum
Identifiers
ISSN of the journal2158-3188
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Creation13/09/2024 10:21:14
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Update time30/09/2024 13:14:02
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