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The following is a summary of “Pharmacogenomics-assisted treatment versus standard of care in schizophrenia: a systematic review and meta-analysis,” published in the October 2024 issue of Psychiatry by Das et al. 

Researchers conducted a retrospective study to evaluate how pharmacogenomic (PGx) factors affect patient response to antipsychotics, comparing PGx-assisted treatment with standard care in schizophrenia. 

They searched PubMed, Embase, and Cochrane CENTRAL databases for randomized controlled trials (RCTs) comparing the clinical utility of PGx-assisted intervention to standard care in schizophrenia from inception to June 2024. The primary outcome was safety, while secondary outcomes included efficacy and medication adherence. They calculated pooled standardized mean differences (SMD) and 95% CI using a random-effects model when feasible. 

The results showed that of the 18,821 studies screened, 5 were included for review, with all RCTs exhibiting a high risk of bias. About 4 studies involved commonly used antipsychotics, with 3 reporting negative outcomes (safety, efficacy, and medication adherence) and two reporting positive outcomes (safety). The meta-analysis revealed significant differences in the total Udvalg for Kliniske Undersogelser Side-Effect Rating scale score [SMD 0.95 (95% CI: 0.76–1.13), P<0.001; I2 = 0%] and the total Positive and Negative Syndrome Scale score [SMD 10.65 (95% CI: 2.37–18.93), P=0.01; I2 = 100%] between PGx-assisted treatment and standard care arms. However, the results were inconsistent, and the certainty of evidence (GRADE criteria) was very low. 

The study concluded that current evidence on the clinical utility of PGx-assisted treatment in schizophrenia was limited and inconsistent, indicating a need for further research. 

Source: bmcpsychiatry.biomedcentral.com/articles/10.1186/s12888-024-06104-4#Abs1