A logistic equation to determine the validity of tramadol from related gene polymorphisms and psychological factors. (March 2014)

• Record Type: Journal Article
• Authors: Zhao, Qin; Sun, Jianguo; Tao, Yifu; Wang, Shukui; Jiang, Chunzhi; Zhu, Yubing; Yu, Feng; Zhu, Junrong
• Is Part Of: Pharmacogenomics. Volume 15:Number 4(2014)
• Page Start: 487
• Page End: 495
• Publication Date: 2014-03
• Subjects: Chinese patients -- pain -- pharmacogenetics -- tramadol response -- upper limb fracture; Pharmacogenomics -- Periodicals; 615.1
• DOI: 10.2217/pgs.14.22
• Languages: English
• ISSNs: 1462-2416

Abstract

Aim: This study was performed to develop an algorithm using polymorphisms of CYP2D6, p-gp, OPRM1, COMT and psychological variables to predict tramadol response in Chinese patients recovering from upper limb fracture internal fixation surgery.Methods: A total of 250 Han Chinese patients recovering from fracture in the upper limb were enrolled. CYP2D6*10, p-gp G2677T, p-gp C3435T, OPRM1 A118G and COMT Val158Met were detected by the ligase detection reaction (LDR) method. The algorithm was developed with binary logistic regression in cohort 1 (200 patients) and assessed with Wilcoxon signed-rank test in cohort 2 (50 patients).Results: According to cohort 1, the predictive equation was calculated with the following logistic regression parameters: Logit (1) = 2.304–4.841 × (anxiety I) – 23.709 × (anxiety II) + 2.823 × ( p-gp 3435CT) + 5.737 × ( p-gp 3435 TT) – 1.586 × ( CYP2D6*10 CT) – 4.542 × ( CYP2D6*10 TT). The cutoff point for the prediction was defined as a probability value ≥0.5. The equation's positive predictive value is 90%. When applied to a new sample, the equation's positive predictive value is 86%. The Nagelkerke R 2 of the model is 0.819, the results of the Hosmer and Leme test show a value of 0.981. The nonparametric correlations between predicted and observed response showed significant correlation (coefficient = 0.879; p < 0.001).Conclusion: The algorithm we have developed might predict tramadol response in Chinese upper limb fracture patients. Original submitted 24 April 2013; Revision submitted 24 January 2014