Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
6
pubmed:dateCreated
2011-5-23
pubmed:abstractText
The antipsychotic drug, olanzapine, one of the most widely used drugs in clinical medicine, has a high rate of discontinuation due to inefficacy and/or adverse effects. We identified a single nucleotide polymorphism in the drug metabolizing enzyme, cytochrome P450 3A43 (CYP3A43; rs472660), that highly significantly predicted olanzapine clearance in the Clinical Antipsychotic Trials of Intervention Effectiveness trial (P=5.9e(-7)). Moreover, at standard antipsychotic doses, 50% of individuals with the high clearance genotype (AA) have trough blood levels below the therapeutic range. Interestingly, a much higher proportion of African Americans carry the A allele compared with Caucasians (allele frequency 67 vs 14%). After accounting for CYP3A43 genotype, race is no longer a significant predictor of olanzapine clearance. Olanzapine clearance was associated with measures of clinical response. Patients with greater clearance had higher symptom ratings and were more likely to discontinue treatment due to an inadequate response. Our data identify a genetic mechanism for variation in olanzapine response and demonstrate that blood level monitoring of olanzapine treatment is advisable.
pubmed:grant
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
IM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Jun
pubmed:issn
1476-5578
pubmed:author
pubmed:issnType
Electronic
pubmed:volume
16
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
620-5
pubmed:meshHeading
pubmed-meshheading:21519338-African Americans, pubmed-meshheading:21519338-Antipsychotic Agents, pubmed-meshheading:21519338-Benzodiazepines, pubmed-meshheading:21519338-Cytochrome P-450 CYP3A, pubmed-meshheading:21519338-European Continental Ancestry Group, pubmed-meshheading:21519338-Female, pubmed-meshheading:21519338-Gene Frequency, pubmed-meshheading:21519338-Genotype, pubmed-meshheading:21519338-Glucose, pubmed-meshheading:21519338-Humans, pubmed-meshheading:21519338-Linear Models, pubmed-meshheading:21519338-Lipid Metabolism, pubmed-meshheading:21519338-Male, pubmed-meshheading:21519338-Models, Chemical, pubmed-meshheading:21519338-Polymorphism, Single Nucleotide, pubmed-meshheading:21519338-Psychiatric Status Rating Scales, pubmed-meshheading:21519338-Schizophrenia, pubmed-meshheading:21519338-Sex Factors, pubmed-meshheading:21519338-Smoking, pubmed-meshheading:21519338-Weight Gain
pubmed:year
2011
pubmed:articleTitle
Genetic variation in CYP3A43 explains racial difference in olanzapine clearance.
pubmed:affiliation
Genes, Cognition, and Psychosis Program, National Institute of Mental Health, NIH, Bethesda, MD, USA.
pubmed:publicationType
Journal Article, Randomized Controlled Trial, Clinical Trial, Phase I, Research Support, N.I.H., Extramural, Research Support, N.I.H., Intramural