(476) Assessing pain perception by genetic testing of COMT haplotypes influences clinical decisions for chronic non-cancer pain patients

Abstract

Researchers have identified candidate genes including catechol-O-methyltransferase (COMT) haplotypes that are associated with pain perception in patients with various chronic non-cancer pain (CNCP) related etiologies. Currently, however, assessment of pain perception is limited to questionnaires and physician interpretation—both of which yield primarily subjective data. Testing for pain perception-related COMT haplotypes provides objective information that may be pertinent to the treatment plan. Hence, the goal of this study was to determine if physicians adjust treatment plans based on genetic tests of pain perception, and whether these treatment changes resulted in better pain relief for patients. A retrospective, cross-sectional study was carried out on 101 CNCP patients. Genotyping for COMT haplotypes was performed using pre-designed TaqMan® single nucleotide polymorphism (SNP) Genotyping Assays (Thermo Fisher Scientific). Genotyping results indicated that 33% of subjects had low pain perception scores; 27% moderate scores; and 23% high scores. Results were not available for 17% of patients. Based on pain perception scores, 23% of physicians adjusted treatment plans. Medication dose changes were made for 6% of patients; further diagnostic testing (electromyography and lumbar puncture) was recommended for 10%; alternative therapy for 7%. Of patients receiving pharmacological interventions, physicians believed 71% of physicians believed patients had a significantly improved or improved response; 14% had no change; and 0% had a worse response. Answers were unavailable for 14% of patients. Thus, although a patient’s pain perception is determined by complex physical, psychological, environmental, cultural, and genetic factors, our results indicate that assessing pain perception via genotyping for COMT haplotypes has a significant effect on clinical decision-making for CNCP patients. In addition, interventions based on objective genetic testing results appeared to improve pain-relief response for these subjects. This study was funded by Proove Biosciences Inc.