De impact van CYP2D6-polymorfisme op een behandeling met aripiprazol bij kinderen en jongeren: een systematische review

Abstract

Impact of CYP2D6 polymorphism on children and adolescents treated with aripiprazole: a systematic review Psychotropic drugs show a significant individual variability in efficacy and adverse events. To explain these differences, there is a promising focus on studies which examine the genetic variants of the cytochrome P450 enzyme 2D6 (CYP2D6). The CYP2D6 gene has a large genetic variability with over 100 known allelic variants encoding this protein. These variants contain predictive value for the function of the CYP2D6 enzyme. Aripiprazole is metabolized by the CYP2D6 enzyme, thereby CYP2D6 allelic variants potentially affect the pharmacokinetics of the drug. This systematic literature review summarizes research on that potential influence of CYP2D6 polymorphism on the treatment outcomes of aripiprazole in minors, in terms of pharmacokinetic changes, efficacy and adverse events. Relevant articles were selected according to PRISMA guidelines (‘preferred reporting items for systematic reviews and meta-analyses’) using Embase and PubMed. After applying the inclusion and exclusion criteria, 10 relevant research articles were retained. The available research shows a possible link between genetic variants of the CYP2D6 enzyme on the one hand, and efficacy and adverse events such as hyperprolactinemia or weight gain on the other hand, in minors treated with aripiprazole. However, the number and quality of studies are low. Recommendations for future studies are made since this systematic review offers insight into the relevance of CYP2D6 genotyping in children and adolescents treated with aripiprazole.