Evaluating the clinical efficacy of combinatorial pharmacogenomic-guided treatment in schizophrenia patients.
This study aims to evaluate the impact of combinatorial pharmacogenomic (CPGx)-guided treatment (CPGT) on medication patterns, symptom remission and hospital stay in patients with schizophrenia.
This retrospective study included schizophrenia patients hospitalized at Shandong Mental Health Center from 2019 to 2022 who underwent self-paid CPGx testing. Based on the temporal sequence of CPGx testing relative to hospitalization, their hospitalizations were classified into the CPGT and the treatment-as-usual (TAU) group. The χ2 and Kruskal-Wallis tests were used to compare the antipsychotics use rate and dosage between the two groups, respectively, and the generalized estimating equation was used to evaluate the effect of CPGx on the percentage change in the Positive and Negative Syndrome Scale (PANSS) score, response and hospital stay.
This study included 895 hospitalization records from 494 patients with schizophrenia, with 331 in the CPGT and 564 in the TAU. CPGT added genotype-related prescriptions such as amisulpride, aripiprazole, risperidone and clozapine in the superior genotype subgroup (P < 0.05), reduced the dosage of risperidone in the slow metabolism subgroup, and increased the doses of clozapine, risperidone, quetiapine and olanzapine in the fast metabolism subgroup (P < 0.05). Compared with TAU, CPGT was associated with a higher percentage change in PANSS score during hospitalization (β = 6.79, 95% CI: 3.26-10.33) and a higher response rate (OR = 1.62; 95% CI, 1.21-2.16). Additionally, the hospital stay in the CPGT group was reduced by 4.80 (95% CI, 1.92-7.68) days.
Our findings demonstrate that CPGx significantly improves treatment outcomes in hospitalized patients with schizophrenia, supporting that CPGx can guide treatment.
This retrospective study included schizophrenia patients hospitalized at Shandong Mental Health Center from 2019 to 2022 who underwent self-paid CPGx testing. Based on the temporal sequence of CPGx testing relative to hospitalization, their hospitalizations were classified into the CPGT and the treatment-as-usual (TAU) group. The χ2 and Kruskal-Wallis tests were used to compare the antipsychotics use rate and dosage between the two groups, respectively, and the generalized estimating equation was used to evaluate the effect of CPGx on the percentage change in the Positive and Negative Syndrome Scale (PANSS) score, response and hospital stay.
This study included 895 hospitalization records from 494 patients with schizophrenia, with 331 in the CPGT and 564 in the TAU. CPGT added genotype-related prescriptions such as amisulpride, aripiprazole, risperidone and clozapine in the superior genotype subgroup (P < 0.05), reduced the dosage of risperidone in the slow metabolism subgroup, and increased the doses of clozapine, risperidone, quetiapine and olanzapine in the fast metabolism subgroup (P < 0.05). Compared with TAU, CPGT was associated with a higher percentage change in PANSS score during hospitalization (β = 6.79, 95% CI: 3.26-10.33) and a higher response rate (OR = 1.62; 95% CI, 1.21-2.16). Additionally, the hospital stay in the CPGT group was reduced by 4.80 (95% CI, 1.92-7.68) days.
Our findings demonstrate that CPGx significantly improves treatment outcomes in hospitalized patients with schizophrenia, supporting that CPGx can guide treatment.