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Article: Effects of Single Nucleotide Polymorphisms on Surgical and Postsurgical Opioid Requirements: A Systematic Review and Meta-analysis

TitleEffects of Single Nucleotide Polymorphisms on Surgical and Postsurgical Opioid Requirements: A Systematic Review and Meta-analysis
Authors
KeywordsAcute postoperative pain
Opioid requirements
Pharmacogenetics
Polymorphisms
Postoperative
Issue Date2017
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://journals.lww.com/clinicalpain/pages/default.aspx
Citation
The Clinical Journal of Pain, 2017, v. 33 n. 12, p. 1117-1130 How to Cite?
AbstractObjectives: There is great heterogeneity in the way individuals respond to medications. Inherited differences, such as single nucleotide polymorphisms (SNP), can influence the efficacy and toxicity of drugs. This meta-analysis aims to collate data from studies investigating the effect of SNPs on postoperative and/or intraoperative opioid requirements. Materials and Methods: A meta-analysis was conducted following PRISMA guidelines. Eligibility criteria for studies included were reporting amount of postoperative and/or intraoperative opioid used as the primary outcome and genotyping patients for SNPs in one of the following genes; OPRM1, CYP2D6, CYP3A4, CYP3A5, COMT, UGT2B7, or ABCB1. A comprehensive systematic search for articles using keywords 'opioid-sensitivity,' 'polymorphisms,' 'post-operative opioid,' 'post-surgical opioid,' 'post-operative pain,' and 'post-surgical pain' was performed. Results: Fifty-one studies were included. Individuals homozygous for AA at the OPRMI (rs1799971) polymorphisms required less postsurgical opioid compared with those homozygous for GG (Hedges g, -0.270; 95% confidence interval, -0.433 to -0.108; P=0.001). Polymorphisms in CYP2D6, CYP3A4, CYP3A5, COMT, UGT2B7, and ABCB1 did not affect opioid requirements. Discussion: Investigation of single changes in 1 gene can only yield limited information regarding genetic effects on opioid requirements. Rapid development of whole genome sequencing enables information on all genetic modifications that may affect analgesic response to be collected. The information collected must include data on the individual's metabolic enzymes, as well as information on drug receptors and enzymes responsible for drug degradation, so that a personal profile can be built up which will predict individual response to drugs, and guide clinicians on the type and dosage of drug to use.
Persistent Identifierhttp://hdl.handle.net/10722/244808
ISSN
2023 Impact Factor: 2.6
2023 SCImago Journal Rankings: 0.921
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorChoi, SW-
dc.contributor.authorLam, DM-
dc.contributor.authorWong, SCS-
dc.contributor.authorShiu, HC-
dc.contributor.authorWang, XMA-
dc.contributor.authorCheung, CW-
dc.date.accessioned2017-09-18T01:59:26Z-
dc.date.available2017-09-18T01:59:26Z-
dc.date.issued2017-
dc.identifier.citationThe Clinical Journal of Pain, 2017, v. 33 n. 12, p. 1117-1130-
dc.identifier.issn0749-8047-
dc.identifier.urihttp://hdl.handle.net/10722/244808-
dc.description.abstractObjectives: There is great heterogeneity in the way individuals respond to medications. Inherited differences, such as single nucleotide polymorphisms (SNP), can influence the efficacy and toxicity of drugs. This meta-analysis aims to collate data from studies investigating the effect of SNPs on postoperative and/or intraoperative opioid requirements. Materials and Methods: A meta-analysis was conducted following PRISMA guidelines. Eligibility criteria for studies included were reporting amount of postoperative and/or intraoperative opioid used as the primary outcome and genotyping patients for SNPs in one of the following genes; OPRM1, CYP2D6, CYP3A4, CYP3A5, COMT, UGT2B7, or ABCB1. A comprehensive systematic search for articles using keywords 'opioid-sensitivity,' 'polymorphisms,' 'post-operative opioid,' 'post-surgical opioid,' 'post-operative pain,' and 'post-surgical pain' was performed. Results: Fifty-one studies were included. Individuals homozygous for AA at the OPRMI (rs1799971) polymorphisms required less postsurgical opioid compared with those homozygous for GG (Hedges g, -0.270; 95% confidence interval, -0.433 to -0.108; P=0.001). Polymorphisms in CYP2D6, CYP3A4, CYP3A5, COMT, UGT2B7, and ABCB1 did not affect opioid requirements. Discussion: Investigation of single changes in 1 gene can only yield limited information regarding genetic effects on opioid requirements. Rapid development of whole genome sequencing enables information on all genetic modifications that may affect analgesic response to be collected. The information collected must include data on the individual's metabolic enzymes, as well as information on drug receptors and enzymes responsible for drug degradation, so that a personal profile can be built up which will predict individual response to drugs, and guide clinicians on the type and dosage of drug to use.-
dc.languageeng-
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://journals.lww.com/clinicalpain/pages/default.aspx-
dc.relation.ispartofThe Clinical Journal of Pain-
dc.rightsThis is a non-final version of an article published in final form in (provide complete journal citation)-
dc.subjectAcute postoperative pain-
dc.subjectOpioid requirements-
dc.subjectPharmacogenetics-
dc.subjectPolymorphisms-
dc.subjectPostoperative-
dc.titleEffects of Single Nucleotide Polymorphisms on Surgical and Postsurgical Opioid Requirements: A Systematic Review and Meta-analysis-
dc.typeArticle-
dc.identifier.emailChoi, SW: htswchoi@hku.hk-
dc.identifier.emailWong, SCS: wongstan@hku.hk-
dc.identifier.emailShiu, HC: hoicshiu@hku.hk-
dc.identifier.emailWang, XMA: xmwang1@hku.hk-
dc.identifier.emailCheung, CW: cheucw@hku.hk-
dc.identifier.authorityWong, SCS=rp01789-
dc.identifier.authorityCheung, CW=rp00244-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1097/AJP.0000000000000498-
dc.identifier.pmid28379874-
dc.identifier.scopuseid_2-s2.0-85017191061-
dc.identifier.hkuros278969-
dc.identifier.hkuros294174-
dc.identifier.volume33-
dc.identifier.issue12-
dc.identifier.spage1117-
dc.identifier.epage1130-
dc.identifier.isiWOS:000415064800009-
dc.publisher.placeUnited States-
dc.identifier.issnl0749-8047-

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