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Working Group Says Evidence Does Not Support CYP450 Testing with Antidepressants

NEW YORK (GenomeWeb News) – A panel formed by the US Centers for Disease Control and Prevention’s National Office of Public Health Genomics has said that it currently would not recommend cytochrome P450 gene testing with selective serotonin reuptake inhibitor drugs used for treating depression.
 
The Evaluation of Genomic Applications in Practice and Prevention Working Group published its report and recommendation in the December issue of the journal Genetics in Medicine, which is published by the American College of Medical Genetics.
 
EGAPP, which is supported by the CDC but is an independent group whose recommendations are not official positions of the CDC or the US Department of Health and Human Services, stressed that its current findings don’t mean that CYP450 testing is not potentially useful, but rather current evidence does not support its use with SSRIs.
 
The working group based its recommendation on a review of research evidence on CYP450 testing by the US Agency for Healthcare Research and Quality, which published its findings in November 2006.
 
According to EGAPP’s paper, researchers found gaps in the research literature and found that current evidence is “insufficient to conclude that there is a relationship between genotype and clinical response.”
 
The panel said that there was no evidence that CYP450 testing predicted the risk of side effects or that test results guided physicians’ selection of SSRIs or dosages.
 
“In the absence of data that testing influences treatment or outcomes, there is a risk that the CYP450 test could increase costs without helping patients,” EGAPP said in a statement. “There is also a possibility of harmful effects, such as less effective treatment or inappropriate use of genetic information.”
 
However, the researchers noted in the recommendation, “It is important to understand that although evidence for the existence of such harms was not found, the potential for their occurrence is nevertheless real.”
 
The EGAPP report suggests future studies that may fill in some of the gaps in knowledge regarding CYP450 testing in conjunction with antidepressant treatment.
 
The CYP450 testing recommendation is the first such recommendation to be issued by EGAPP.