Meta-analysis of the effects of gene polymorphism on the efficacy and safety of citalopram/escitalopram
- VernacularTitle:基因多态性对西酞普兰/艾司西酞普兰有效性与安全性影响的Meta分析
- Author:
Shidi CHEN
1
;
Jin ZHAO
1
;
Fang LIU
1
,
2
;
Zhanmiao YI
2
Author Information
1. Dept. of Pharmacy，Beijing Haidian Hospital，Beijing 100080，China
2. Dept. of Pharmacy，Peking University Third Hospital，Beijing 100191，China
- Publication Type:Journal Article
- Keywords:
citalopram;
escitalopram;
efficacy;
safety
- From:
China Pharmacy
2023;34(14):1748-1754
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE To evaluate the effects of gene polymorphism on the efficacy and safety of citalopram/escitalopram， and to provide evidence-based reference for precision medication. METHODS Retrieved from PubMed， Embase， the Cochrane Library， CNKI， Wanfang data and SinoMed， clinical studies about the association of gene polymorphism with efficacy and safety of citalopram/escitalopram were collected. Meta-analysis was performed with RevMan 5.3 software after literature screening， data extraction and quality evaluation based on Newcastle-Ottawa scale. RESULTS Totally 35 pieces of literature were included， all of which were cohort studies， with a total of 9 836 patients. Meta-analysis showed that the SLC6A4 gene 5-serotonin transporter linked polymorphic region （HTTLPR） LL genotype was associated with high response rate of citalopram/escitalopram [LS/SS vs. LL： OR＝0.47， 95%CI （0.22， 0.98）， P＝0.05]； results of subgroup analysis suggested a higher correlation in white people with LL genotype and escitalopram； there was no significant correlation of HTTLPR genotype with remission rate [LS/SS vs. LL： OR＝ 0.92，95%CI（0.77， 1.10）， P＞0.05； SS vs. LL/LS：OR＝0.73， 95%CI（0.45， 1.19）， P＞0.05] or overall incidence of ADR in patients with gene SLC6A4； but high expression of rs25531 LA was significantly associated with reduced incidence of ADR（P＜ 0.05）. CYP2C19*2/*3 allele was significantly associated with slowed metabolism， higher response rate and increased incidence of ADR. CONCLUSIONS HTTLPR LL genotype is associated with the increased response rate of citalopram/escitalopram， but no significant correlation with safety is found， while CYP2C19*2/*3 allele is significantly associated with higher response rate and reduced tolerability.
