Pharmacogenomics and prescription opioid use

Genome-wide association studies and candidate gene findings suggest that genetic approaches may help in choosing the most appropriate drug and dosage, while preventing adverse drug reactions. This is the field that addresses Precision Medicine: to evaluate variations in the DNA sequence that could be responsible for different individual analgesic response. We review potential gene biomarkers with best overall convergent functional evidence, for opioid use, in pain management. Polymorphisms can modify pharmacodynamics (i.e., mu opioid receptor, OPRM1) and pharmacokinetics (i.e., CYP2D6 phenotypes) pathways altering opioid effectiveness, consumption, side effects or additionally, prescription opioid use dependence vulnerability. This review provides a summary of these candidate variants for the translation of genotype into clinically useful information in pain medicine. Lay abstract: Pharmacogenetics is the study of inherited genetic traits that result in individual responses to drugs. This review will attempt to cover the current understanding of opioid use for pain management. Gene variants could modify metabolism of analgesic medications, their distribution throughout the body and end organ effects. These variants need to be validated to provide an understanding of how to incorporate genetic testing into routine use to improve pain clinical practice and patient management.

Automated summary

Genetic approaches can aid in drug selection and dosage optimization while preventing adverse reactions, particularly in personalized pain management through studying gene biomarkers that influence individual responses to analgesics.