Literature DB >> 35393395

Genome-wide association analyses of symptom severity among clozapine-treated patients with schizophrenia spectrum disorders.

C Okhuijsen-Pfeifer1,2, M Z van der Horst1,2,3, C A Bousman4,5,6,7, B Lin1,2, K R van Eijk2, S Ripke8, Y Ayhan9, M O Babaoglu10, M Bak11,12, W Alink13, H van Beek14, E Beld15, A Bouhuis16, M Edlinger17, I M Erdogan9, A Ertuğrul9, G Yoca9,18, I P Everall7,19, T Görlitz20,21, K P Grootens22,23, S Gutwinski8, T Hallikainen24, E Jeger-Land25, M de Koning25,26, M Lähteenvuo24, S E Legge27, S Leucht28, C Morgenroth8, A Müderrisoğlu29, A Narang4, C Pantelis7, A F Pardiñas27, T Oviedo-Salcedo20, J Schneider-Thoma28, S Schreiter8,30, E Repo-Tiihonen24, H Tuppurainen24, M Veereschild3, S Veerman31, M de Vos3, E Wagner20, D Cohen32, J P A M Bogers33, J T R Walters27, A E Anil Yağcıoğlu9, J Tiihonen24,34,35, A Hasan20,21, J J Luykx36,37,38.   

Abstract

Clozapine is the most effective antipsychotic for patients with treatment-resistant schizophrenia. However, response is highly variable and possible genetic underpinnings of this variability remain unknown. Here, we performed polygenic risk score (PRS) analyses to estimate the amount of variance in symptom severity among clozapine-treated patients explained by PRSs (R2) and examined the association between symptom severity and genotype-predicted CYP1A2, CYP2D6, and CYP2C19 enzyme activity. Genome-wide association (GWA) analyses were performed to explore loci associated with symptom severity. A multicenter cohort of 804 patients (after quality control N = 684) with schizophrenia spectrum disorder treated with clozapine were cross-sectionally assessed using the Positive and Negative Syndrome Scale and/or the Clinical Global Impression-Severity (CGI-S) scale. GWA and PRS regression analyses were conducted. Genotype-predicted CYP1A2, CYP2D6, and CYP2C19 enzyme activities were calculated. Schizophrenia-PRS was most significantly and positively associated with low symptom severity (p = 1.03 × 10-3; R2 = 1.85). Cross-disorder-PRS was also positively associated with lower CGI-S score (p = 0.01; R2 = 0.81). Compared to the lowest tertile, patients in the highest schizophrenia-PRS tertile had 1.94 times (p = 6.84×10-4) increased probability of low symptom severity. Higher genotype-predicted CYP2C19 enzyme activity was independently associated with lower symptom severity (p = 8.44×10-3). While no locus surpassed the genome-wide significance threshold, rs1923778 within NFIB showed a suggestive association (p = 3.78×10-7) with symptom severity. We show that high schizophrenia-PRS and genotype-predicted CYP2C19 enzyme activity are independently associated with lower symptom severity among individuals treated with clozapine. Our findings open avenues for future pharmacogenomic projects investigating the potential of PRS and genotype-predicted CYP-activity in schizophrenia.
© 2022. The Author(s).

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Year:  2022        PMID: 35393395      PMCID: PMC8989876          DOI: 10.1038/s41398-022-01884-3

Source DB:  PubMed          Journal:  Transl Psychiatry        ISSN: 2158-3188            Impact factor:   7.989


  55 in total

Review 1.  Delayed Initiation of Clozapine Continues to Be a Substantial Clinical Concern.

Authors:  Alexander Panickacheril John; Elvin Kay Fon Ko; Arun Dominic
Journal:  Can J Psychiatry       Date:  2018-04-22       Impact factor: 4.356

Review 2.  Clozapine Response Rates among People with Treatment-Resistant Schizophrenia: Data from a Systematic Review and Meta-Analysis.

Authors:  Dan Siskind; Victor Siskind; Steve Kisely
Journal:  Can J Psychiatry       Date:  2017-06-28       Impact factor: 4.356

3.  Prior antipsychotic prescribing in patients currently receiving clozapine: a case note review.

Authors:  David M Taylor; Corina Young; Carol Paton
Journal:  J Clin Psychiatry       Date:  2003-01       Impact factor: 4.384

4.  The Schizophrenia Patient Outcomes Research Team (PORT): updated treatment recommendations 2009.

Authors:  Julie Kreyenbuhl; Robert W Buchanan; Faith B Dickerson; Lisa B Dixon
Journal:  Schizophr Bull       Date:  2009-12-02       Impact factor: 9.306

5.  Clozapine and Long-Term Mortality Risk in Patients With Schizophrenia: A Systematic Review and Meta-analysis of Studies Lasting 1.1-12.5 Years.

Authors:  Jentien M Vermeulen; Geeske van Rooijen; Marita P J van de Kerkhof; Arjen L Sutterland; Christoph U Correll; Lieuwe de Haan
Journal:  Schizophr Bull       Date:  2019-03-07       Impact factor: 9.306

Review 6.  Clozapine v. first- and second-generation antipsychotics in treatment-refractory schizophrenia: systematic review and meta-analysis.

Authors:  Dan Siskind; Lara McCartney; Romi Goldschlager; Steve Kisely
Journal:  Br J Psychiatry       Date:  2016-07-07       Impact factor: 9.319

7.  Adherence to treatment guidelines in clinical practice: study of antipsychotic treatment prior to clozapine initiation.

Authors:  Oliver D Howes; Francis Vergunst; Siobhan Gee; Philip McGuire; Shitij Kapur; David Taylor
Journal:  Br J Psychiatry       Date:  2012-09-06       Impact factor: 9.319

8.  The expert consensus guideline series. Optimizing pharmacologic treatment of psychotic disorders. Introduction: methods, commentary, and summary.

Authors:  John M Kane; Stefan Leucht; Daniel Carpenter; John P Docherty
Journal:  J Clin Psychiatry       Date:  2003       Impact factor: 4.384

9.  Clozapine as a first- or second-line treatment in schizophrenia: a systematic review and meta-analysis.

Authors:  C Okhuijsen-Pfeifer; E A H Huijsman; A Hasan; I E C Sommer; S Leucht; R S Kahn; J J Luykx
Journal:  Acta Psychiatr Scand       Date:  2018-09-14       Impact factor: 6.392

Review 10.  Treatment-Resistant Schizophrenia: Treatment Response and Resistance in Psychosis (TRRIP) Working Group Consensus Guidelines on Diagnosis and Terminology.

Authors:  Oliver D Howes; Rob McCutcheon; Ofer Agid; Andrea de Bartolomeis; Nico J M van Beveren; Michael L Birnbaum; Michael A P Bloomfield; Rodrigo A Bressan; Robert W Buchanan; William T Carpenter; David J Castle; Leslie Citrome; Zafiris J Daskalakis; Michael Davidson; Richard J Drake; Serdar Dursun; Bjørn H Ebdrup; Helio Elkis; Peter Falkai; W Wolfgang Fleischacker; Ary Gadelha; Fiona Gaughran; Birte Y Glenthøj; Ariel Graff-Guerrero; Jaime E C Hallak; William G Honer; James Kennedy; Bruce J Kinon; Stephen M Lawrie; Jimmy Lee; F Markus Leweke; James H MacCabe; Carolyn B McNabb; Herbert Meltzer; Hans-Jürgen Möller; Shinchiro Nakajima; Christos Pantelis; Tiago Reis Marques; Gary Remington; Susan L Rossell; Bruce R Russell; Cynthia O Siu; Takefumi Suzuki; Iris E Sommer; David Taylor; Neil Thomas; Alp Üçok; Daniel Umbricht; James T R Walters; John Kane; Christoph U Correll
Journal:  Am J Psychiatry       Date:  2016-12-06       Impact factor: 18.112

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