Pharmacogenomic biomarkers as source of evidence of the effectiveness and safety of antidepressant therapy

Correia, Catarina; Alcobia, Luciano; Lopes, Manuel J.; Advinha, Ana M.

http://hdl.handle.net/10400.1/18229

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Objective: The main goal of this work was to identify, describe, characterize, and classify the scientifc evidence regarding the use of pharmacogenomic biomarkers in antidepressant treatment. Methods: The work was developed in two phases: i) a search for pharmacogenomic biomarkers in summaries of antidepressant drugs with marketing authorization in Portugal; and ii) a systematic literature review based on the data obtained in the frst phase, with the main objective of fnding international literature that could describe and characterize previously reported biomarkers and identify other relevant biomarkers. Finally, the levels of evidence and recommendation grades were classifed. Results: Among the 26 drugs with marketing authorization in Portugal, only 16 had pharmacogenomic information. The most widely studied pharmacogenomic biomarker was CYP2D6. These results were mostly supported by the systematic literature review, which yielded 103 papers, 63 of which were ultimately included in the review. The sys‑ tematic literature review also revealed the existence of other relevant biomarkers. Most of the included studies show a good level of evidence, which guarantees reliability and good recommendation grades. For the database (built during phase i), the results were informative but resulted in no specifc recommendations. Conclusions: Most pharmacogenomic variants are not studied or acknowledged by genetic tests, and more scien‑ tifc research is needed to confrm their usefulness. Therefore, only a small number of variants are considered when prescribing antidepressant drugs. In addition, genotyping of patients is not common in clinical practice.