Pharmacogenetic testing shows promise improving symptoms in patients
with treatment-resistant depression

Date:
March 29, 2022
Source:
Centre for Addiction and Mental Health
Summary:
Pharmacogenetic testing was associated with nearly a two-fold
(89 per cent) increase in remission rates compared to treatment
as usual in a recent clinical study.



FULL STORY ========================================================================== Pharmacogenetic testing was associated with nearly a two-fold (89 per
cent) increase in remission rates compared to treatment as usual in a
Centre for Addiction and Mental Health- (CAMH-)led clinical study just published in the journalTranslational Psychiatry.


==========================================================================
The 52-week double-blind study, comparing pharmacogenetic testing guided treatment to treatment as usual, is the first of its kind in Canada and involved 276 patients who had been previously diagnosed with treatment- resistant depression, meaning that their condition had not improved
after trying at least two antidepressant medications.

"Remission, or full recovery from symptoms, is one of the most challenging endpoints to achieve when treating major depressive disorder,"
said senior author Dr. James Kennedy, Head of the Tanenbaum Centre
for Pharmacogenetics at the Campbell Family Mental Health Research
Institute at CAMH. "The findings from this study contribute the first randomized, controlled data in Canada to the growing body of evidence
of the clinical value of combined multi-gene pharmacogenetic testing." Pharmacogenetics is based on the premise that each person may metabolize
or respond to medications in different ways based on their own individual genetic profile. That can mean that patients given the same dosage of an
anti- depressant medication may have very different levels of it in their bodies, or that some patients may be able to tolerate higher doses of a
drug without debilitating side effects based on their genetics. Through customized genetic testing via a cheek swab, pharmacogenetics can help
select appropriate drugs and dosages for each patient with the fewest
side effects in the shortest period of time.

"Myriad Genetics is proud to support this important study that
advances our knowledge of the utility of pharmacogenetic testing in
Canadian patients suffering from treatment-resistant major depressive disorder," said Jay Elliott, Vice President of Medical Affairs at
Myriad Genetics. "Although the CAMH trial was underpowered, it is
encouraging that the results largely replicate prior studies in American patients, reinforcing the generalizability of pharmacogenetic testing
for depression across health care settings." "Using pharmacogenetics
for treatment-resistant depression we can be much more precise about
exactly which drug will suit each person's unique blueprints for the
bodily systems that usher the drug into the brain and enable it to
fight depression," said Dr. Kennedy. "It's very personalized to each individual." At the recommendation of her doctor, Toronto lawyer Cara
Sweeny turned to pharmacogenetics at CAMH after not responding to a
variety of medications for depression and anxiety. After genetic testing determined her body could tolerate -- and in fact needed -- three times
the standard dose of one anti- depressant drug, she was given the higher
dose and within two months her mood improved dramatically.

"I have this very specific memory of one day just opening up my back
door to let my dog out, just an ordinary thing, and I felt that feeling
of happiness that starts in your gut for the first time in a really long
time," says Sweeny, 52.

While the findings of this Canadian study are considered preliminary
because of the sample size, they mirror the results of a much larger
American pharmacogenetics clinical trial that reported a 51 per cent
increase in remission rates for major depression compared to treatment
as usual.

"Pharmacogenetic tests are currently not covered by public health plans
in Canada," added Dr. Kennedy. "The average healthcare savings following pharmacogenetic testing, per depression patient, are over $3,000. If
half of the 1.6 million Canadians with depression could get the test,
savings could total $2.4 billion per year. Patient suffering during trial-and-error prescribing would be reduced. These study findings
should be considered by health policy decision makers, as they provide
further impetus for implementation of reimbursement by public payers."
Funding for the study was provided by Assurex Health Ltd. (now affiliated
with Myriad Genetics), CAMH, Ontario Genomics and Genome Canada.


========================================================================== Story Source: Materials provided by
Centre_for_Addiction_and_Mental_Health. Note: Content may be edited for
style and length.


========================================================================== Journal Reference:
1. 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. Mu"ller, Robert Levitan, Stefan Kloiber, Zafiris
J. Daskalakis, 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. Clinical utility of combinatorial pharmacogenomic
testing in depression: A Canadian patient- and rater-blinded,
randomized, controlled trial. Translational Psychiatry, 2022; 12
(1) DOI: 10.1038/s41398-022-01847-8 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2022/03/220329090730.htm

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