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Genetics can be used to predict a patient's response to antipsychotic treatment of schizophrenia, according to a recent study by researchers at the Feinstein Institute for Medical Research. The results were published online today in the American Journal of Psychiatry.
Schizophrenia is one of the leading causes of disability in the United States. It is characterized by delusions, hallucinations and disorganized thoughts and behaviors. The disease is currently treated with antipsychotics, but this therapy is administered without the help of laboratory tests to demonstrate its effectiveness, as is common in other areas of medicine. Doctors often use "trial and error" to choose a treatment for schizophrenia, without knowing if patients will respond well. This uncertainty weighs heavily not only on patients and their families, but also on health professionals and health systems.
For this study, Todd Lencz, a professor at the Feinstein Institute, and his team used genetic tests to predict the ultimate drug response in patients with the first episode of schizophrenia. Rather than looking for a single gene, the researchers used a relatively new approach called "polygenic risk scores".
"Polygenic risk scores represent the combined effects of several thousand genomic variants on the entire genome and better represent the highly complex genetic nature of schizophrenia," said Jian-Ping Zhang, MD, PhD, assistant professor. at the Feinstein Institute and lead author. of the study.
The researchers found that patients with a high polygenic risk score or a higher genetic burden were less likely to respond to conventional antipsychotic treatment. These results have been replicated in two independent cohorts, representing an international collaboration between scientists from the Feinstein Institute and researchers from across Europe, stressing that this approach should be explored further.
"The findings we found open the door to" precision medicine "approaches in psychiatry, and more specifically to the use of polygene scores as a new technology for the treatment of psychiatric disorders," he said. Dr. Lencz.
The researchers hope to expand the study, the ultimate goal being to develop clinical guidelines for the use of polygenic risk scores and other predictors (such as brain scans) in the treatment of schizophrenia.
"The work of Dr. Lencz and Dr. Zhang constitute a major breakthrough in the field of precision medicine for schizophrenia," said Kevin J. Tracey, MD, president and CEO of the Feinstein Institute. "A therapy tailored to the patient's polygenic risk scores is potentially a major advance over current trial and error approaches.
Source:
https://www.northwell.edu/
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