Surgery Clinical Trial
Official title:
Prospective Randomized Clinical Study to Evaluate the Clinical Impact of Pharmacogenetics-Guided Treatment for Patients Undergoing Elective Spinal Surgical Procedures
The purpose of this study is to evaluate the effect of pharmacogenetic (PGx) guided treatment when implemented into the pre-operative process for patients undergoing an elective spinal surgical procedure and requiring post-operative acute pain management, as compared to a group of subjects with the same attributes without the guidance of PGx testing for their post-surgery pain management. This study will also evaluate whether PGx testing can reduce narcotic consumption, opioid-related adverse effects, time to mobilization, medical visits and costs.
The incidence of opioid related adverse drug events can reach as high as 50% in surgical
patients and poor pain management is a significant risk factor for early readmission. In
addition, the rate of non- response to certain analgesics is double in patients who are poor
metabolizers as demonstrated by mutations in both CPY26d alleles. Finally, there is a growing
body of literature that ineffective acute pain management contributes significantly to the
risk of chronic pain syndromes. Genetics and drug interactions can alter both the
pharmacokinetics and pharmacodynamics of a multitude of drug compounds and in turn influence
both the safety and efficacy of selected therapeutic regimens.
Pharmacogenetic-guided therapy selection can enhance patient response by facilitating the
selection of the most appropriate medication at the most effective dose in the shortest
possible time.
In this prospective, randomized, single-blind study, the investigators will evaluate the
clinical impact of pharmacogenetics-guided treatment on the duration of the post-surgical
hospital stay and on patient well-being as determined by post-op pain assessments.
Additionally, the impact of PGx-guided treatment on narcotic consumption, number of adverse
events, re-admission rates and costs will be evaluated during the study duration.
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