Literature DB >> 34488071

Analysis of genetic and clinical factors associated with buprenorphine response.

Richard C Crist1, Rachel Vickers-Smith2, Rachel L Kember1, Christopher T Rentsch3, Heng Xu4, E Jennifer Edelman5, Emily E Hartwell6, Kyle M Kampman1, Henry R Kranzler7.   

Abstract

BACKGROUND: Buprenorphine, approved for treating opioid use disorder (OUD), is not equally efficacious for all patients. Candidate gene studies have shown limited success in identifying genetic moderators of buprenorphine treatment response.
METHODS: We studied 1616 European-ancestry individuals enrolled in the Million Veteran Program, of whom 1609 had an ICD-9/10 code consistent with OUD, a 180-day buprenorphine treatment exposure, and genome-wide genotype data. We conducted a genome-wide association study (GWAS) of buprenorphine treatment response [defined as having no opioid-positive urine drug screens (UDS) following the first prescription]. We also examined correlates of buprenorphine treatment response in multivariable analyses.
RESULTS: Although no variants reached genome-wide significance, 6 loci were nominally significant (p < 1 × 10-5), four of which were located near previously characterized genes: rs756770 (ADAMTSL2), rs11782370 (SLC25A37), rs7205113 (CRISPLD2), and rs13169373 (LINC01947). A higher maximum daily buprenorphine dosage (aOR = 0.98; 95 %CI: 0.97, 0.995), greater number of UDS (aOR = 0.97; 95 %CI: 0.96, 0.99), and history of hepatitis C (HCV) infection (aOR = 0.71; 95 %CI: 0.57, 0.88) were associated with a reduced odds of buprenorphine response. Older age (aOR: 1.01; 95 %CI: 1.000, 1.02) was associated with increased odds of buprenorphine response.
CONCLUSIONS: This study had limited statistical power to detect genetic variants associated with a complex human phenotype like buprenorphine treatment response. Meta-analysis of multiple data sets is needed to ensure adequate statistical power for a GWAS of buprenorphine treatment response. The most robust phenotypic predictor of buprenorphine treatment response was intravenous drug use, a proxy for which was HCV infection. Published by Elsevier B.V.

Entities:  

Keywords:  Buprenorphine; Genetics; Genome-wide association study; Opioid use disorder; Treatment predictors; Treatment response

Mesh:

Substances:

Year:  2021        PMID: 34488071      PMCID: PMC9328121          DOI: 10.1016/j.drugalcdep.2021.109013

Source DB:  PubMed          Journal:  Drug Alcohol Depend        ISSN: 0376-8716            Impact factor:   4.852


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