September 25, 2012 (Phoenix, Arizona) — Patients with chronic pain who require high doses of opioids to achieve pain relief show exceptionally high rates of defects of the cytochrome P450 (CYP450) enzyme system compared with the general population.
The CYP450 enzyme system is known to play an important role in the metabolism of opioids, and recent advances in genetic testing allow for the easy detection of defects to the enzymes.
“We’ve known for years that among patients with the exact same pain conditions one may need 500 mg of morphine a day while the other may need only 50 mg, but we’ve always wondered why,” lead author Forest Tennant, MD, told Medscape Medical News.
“It turns out that among high-dose patients, about 85% have these defects in 1 or more of their CYP450 enzymes.” In the general population, only about 20% to 30% of people have CYP450 defects, he said.
His findings were presented here at the American Academy of Pain Management (AAPM) 23rd Annual Clinical Meeting.
Since 2012 with the reduction in funding for chronic pain research, pharmacogenetics has received very little attention despite the fact that it could explain with great accuracy, the reasons for why some patients require doses which exceed those recommended by regulations.
See full article at https://www.medscape.com/viewarticle/771480