Improving Pain Management with Pharmacogenomics: A General Introduction

Schuh, Michael J.; Randles, Heather J.; Crosby, Sheena

doi:10.1080/15360288.2020.1734140

Cited by 2 publications

(4 citation statements)

References 15 publications

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“…According to the International Association for the Study of Pain (IASP), pain is defined as an unpleasant sensory and emotional experience connected with actual or potential tissue damage, or described in terms of such damage ( Raja et al, 2020 ). Excessive pain can significantly increase psychological health problems and affects the quality of life ( Schuh et al, 2020 ). Pain includes several types such as neuropathic, nociceptive and nociplastic depending on its neuropsychological cause and duration ( Isagulyan et al, 2022 ).…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, individualized pain management for each patient is important for alleviating patient suffering and morbidity. Furthermore, tailoring the individual’s treatment can improve analgesic outcomes by maximizing efficacy and minimizing toxicities ( Mahajan, 2014 ; Schuh et al, 2020 ). Interindividual diversity in pain management therapies is mainly driven by behavior, expectations, gender, renal function, psychosocial distress, ethnic origin and genetic variability ( Molanaei et al, 2010 ).…”

Section: Introductionmentioning

confidence: 99%

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Pharmacogenetic landscape of pain management variants among Mediterranean populations

Jmel,

Boukhalfa,

Gouiza

et al. 2024

Front. Pharmacol.

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Background:Chronic pain is a major socioeconomic burden in the Mediterranean region. However, we noticed an under-representation of these populations in the pharmacogenetics of pain management studies. In this context, we aimed 1) to decipher the pharmacogenetic variant landscape among Mediterranean populations compared to worldwide populations in order to identify therapeutic biomarkers for personalized pain management and 2) to better understand the biological process of pain management through in silico investigation of pharmacogenes pathways.Materials and Methods:We collected genes and variants implicated in pain response using the Prisma guidelines from literature and PharmGK database. Next, we extracted these genes from genotyping data of 829 individuals. Then, we determined the variant distribution among the studied populations using multivariate (MDS) and admixture analysis with R and STRUCTURE software. We conducted a Chi2 test to compare the interethnic frequencies of the identified variants. We used SNPinfo web server, miRdSNP database to identify miRNA-binding sites. In addition, we investigated the functions of the identified genes and variants using pathway enrichment analysis and annotation tools. Finally, we performed docking analysis to assess the impact of variations on drug interactions.Results:We identified 63 variants implicated in pain management. MDS analysis revealed that Mediterranean populations are genetically similar to Mexican populations and divergent from other populations. STRUCTURE analysis showed that Mediterranean populations are mainly composed of European ancestry. We highlighted differences in the minor allele frequencies of three variants (rs633, rs4680, and rs165728) located in the COMT gene. Moreover, variant annotation revealed ten variants with potential miRNA-binding sites. Finally, protein structure and docking analysis revealed that two missense variants (rs4680 and rs6267) induced a decrease in COMT protein activity and affinity for dopamine.Conclusion:Our findings revealed that Mediterranean populations diverge from other ethnic groups. Furthermore, we emphasize the importance of pain-related pathways and miRNAs to better implement these markers as predictors of analgesic responses in the Mediterranean region.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Pharmacogenetic landscape of pain management variants among Mediterranean populations

Jmel,

Boukhalfa,

Gouiza

et al. 2024

Front. Pharmacol.

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“…5,6 Several studies and healthcare settings have observed improvement in pain management with PGx integration and recognized individualized therapy promotes medication safety. 3,6 Furthermore, PGx results provide objective information to facilitate conversations between healthcare providers and patients about why opioid therapy may or may not be safe and/or appropriate. 7,8 Problems with drug-gene interactions (DGIs) have been well established for analgesics, such as with cytochrome P450 (CYP)2D6 and certain opioids (eg, codeine, tramadol, oxycodone, hydrocodone).…”

Section: Introductionmentioning

confidence: 99%

“…These changes can result in increased risk for opioid-related adverse drug events (ADEs), such as respiratory depression and/or pharmacotherapy failure. 5 , 6 Several studies and healthcare settings have observed improvement in pain management with PGx integration and recognized individualized therapy promotes medication safety. 3 , 6 Furthermore, PGx results provide objective information to facilitate conversations between healthcare providers and patients about why opioid therapy may or may not be safe and/or appropriate.…”

Section: Introductionmentioning

confidence: 99%

Utilizing Pharmacogenomics Results to Determine Opioid Appropriateness and Improve Pain Management in a Patient with Osteoarthritis

Pizzolato¹,

Thacker²,

Toro-Pagán³

et al. 2022

PGPM

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The opioid epidemic in the United States has exposed the need for providers to limit opioid dispensing and identify at-risk patients prior to prescribing opioids. With pharmacogenomic testing, clinicians can analyze hundreds of medications-including commonly prescribed opioids-against genetic results to understand and predict risk and response. Moreover, knowledge of genotypic variants and altered function can help decrease trial and error prescribing, identify patients at-risk for adverse drug events, and improve pain control. This patient case demonstrates how pharmacogenomic test results identified drug-gene interactions and provided insight about a patient's inadequate opioid therapy response. With pharmacogenomic information, the patient's healthcare team discontinued opioid therapy and selected a more appropriate regimen for osteoarthritis (ie, celecoxib), resulting in improved pain control and quality of life.

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Improving Pain Management with Pharmacogenomics: A General Introduction

Cited by 2 publications

References 15 publications

Pharmacogenetic landscape of pain management variants among Mediterranean populations

Pharmacogenetic landscape of pain management variants among Mediterranean populations

Utilizing Pharmacogenomics Results to Determine Opioid Appropriateness and Improve Pain Management in a Patient with Osteoarthritis

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