Effectiveness of a pharmacogenetic tool at improving treatment efficacy in major depressive disorder: A meta‐analysis of three clinical studies

Abstract

Several pharmacogenetic tests to support drug selection in psychiatric patients have recently become available. The current meta‐analysis aimed to assess the clinical utility of a commercial pharmacogenetic based tool for psychiatry (Neuropharmagen®) in the treatment management of depressive patients. Random‐effects meta‐analysis of clinical studies that had examined the effect of this tool on the improvement of depressive patients was performed. Effects were summarized as standardized differences between treatment groups. A total of 450 eligible subjects from three clinical studies were examined. The random effects model estimated a statistically significant effect size for the pharmacogenetic guided prescription (d = 0.34, 95% CI = 0.11–0.56, p‐value = 0.004), which corresponded to approximately a 1.8 fold increase in the odds of clinical response for pharmacogenetic guided vs. unguided drug selection. After exclusion of patients with mild depression, the pooled estimated effect size increased to 0.42 (95% CI = 0.19–0.65, p value = 0.004, n = 287), corresponding to an OR = 2.14 (95% CI = 1.40–3.27). These results support the clinical utility of this pharmacogenetic based tool in the improvement of health outcomes in patients with depression, especially those with moderate–severe depression. Additional pragmatic RCTs are warranted to consolidate these findings in other patient populations.