A pilot study of pharmacogenomic testing as a tool to enhance depression care in Veterans

CYP2C19, CYP2D6, CYP2C9, CYP3A5, SLCO1B1, DPYD, TPMT (Sanford panel)

Pragmatic randomized trial (n=60 depressed veterans): immediate vs delayed availability of multigene PGx panel results (8 genes, Sanford panel); assessment of actionability and prescribing impact

Pragmatic pilot randomized clinical trial (12 weeks, n=60 depressed veterans, Philadelphia) comparing immediate vs delayed availability of multigene PGx panel results (Sanford panel, 8 genes). 30% of participants had at least one actionable gene-drug interaction, vs 20% in previous veteran studies. The absence of PHQ-9 difference between arms at 12 weeks reflects the insufficient size of this pilot trial.

Synthesis written by Geno'X. For the full original abstract, please refer to the source publication.

The added value is demonstrating that targeting PGx genotyping toward patients in psychiatric polypharmacy increases clinical yield (30% vs 20% expected). The underpowered pilot trial does not allow conclusions on clinical impact — a phase III trial is needed. For laboratory physicians: argument for a preemptive multigene panel in psychiatric patients on complex regimens.

pragmatic RCT +2; 30% actionable interactions (above 20% expected) +2; vulnerable population (veterans) +1; Pharmacogenomics J +1; multigene panel implementation +1