Chronic Pain Clinical Trial
Official title:
Exploratory Study of Cytochrome P450's Pharmacogenomics in Chronic Pain Patients
The use of titrated drugs is at the base of a successful antalgic treatment in order to
provide both an adequate relief and a satisfactory tolerability profile. These molecules,
though, have a varying degree of efficacy in different subjects due to medical and genetic
reasons. The latter are mainly represented by cytochrome (CYP) P450, in particular CYP2D6's
polymorphisms are responsible for the diversified metabolism of analgesics used in chronic
pain treatments.
Four main types of enzymatic metabolism make up the population, each one defined by a
different CYP2D6 allele: extensive metabolizers, ultra-rapid metabolizers, intermediate
metabolizers and poor metabolizers.
Moreover, regarding polytherapies, the analgesics' metabolism could be influenced by
coadministration of other drugs, thus determining an inhibition or induction of the metabolic
enzymes - known as phenocopying - and potentially also a change in the metabolic phenotype
itself. The final outcome is the inconstancy of effectiveness and of the risk of developing
side effects.
The primary objective of this study is to define a genetic pattern for the gene CYP2D6 by
assessing the incidence of poor or ultrarapid metabolizers in a population of chronic pain
patients. This will also allow to observe phenocopying in the same population.
Hence 100 patients diagnosed with chronic pain will be enrolled. The genetic pattern of the
gene CYP2D6 of such patients will be examined by taking mouth samples. At the same time
parametric tests for paired data to survey the correlations between phenotypical patterns and
pharmacological therapies will be conducted.
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