Multigenetic pharmacogenomics-guided treatment more effective for treatment of schizophrenia

1. This randomized clinical trial demonstrated that multigenetic pharmacogenomics-guided treatment (MPGT) had higher response and remission rates in the treatment of schizophrenia compared with treatment as usual (TAU).

Evidence Rating Level: 1 (Excellent)

Schizophrenia—a condition characterized by disruptions in various mental modalities—affects approximately 24 million people globally and imposes a significant disease burden. First-line treatment with antipsychotics is effective for only 20-50% of patients, often leading to a trial-and-error approach to finding an effective treatment. This randomized clinical trial aims to evaluate the efficacy of MPGT in hospitalized men with schizophrenia compared with TAU. 210 male inpatients in Guiyang, China with a diagnosis of schizophrenia were enrolled and randomized in a 1:1 ratio, with both participants and raters masked to the allocation. 113 patients received MPGT, medication regimens tailored to their genetic profiles, and 97 received TAU. MPGT was associated with a significantly greater reduction in the Positive and Negative Syndrome Scale (PANSS) score than TAU at week 12 (83.5% vs 76.1%; P = .001). The response rates, defined as a 20% or greater reduction in PANSS scores, at the end of week 6 were significantly higher in the MPGT group compared to the TAU group (adjusted odds ratio, 2.48; 95% CI, 1.28-4.80; P = .01). Symptomatic remission rates, defined as a PANSS total score of 70 or less, were also higher in the MPGT group (adjusted odds ratio, 2.03; 95% CI, 1.11-3.60; P = .02). While this study is limited by the inclusion of only male Chinese Han patients, these findings suggest that MPGT proved superior to TAU in treating schizophrenia patients, indicating that multigenetic pharmacogenomic testing could be a valuable tool for guiding schizophrenia treatment.

Click to read the study in JAMA Network Open

Image: PD

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