Research presented at the American Association for Clinical Chemistry Annual Scientific Meeting & Clinical Lab Expo indicated accuracy of a genetic risk assessment for prescription or heroin opioid addiction.
“Test results show that many of the genetic mutations identified in this test panel — namely receptors and transporters — are present in most chronic pain patients and are helpful in identifying those subjects at risk for addiction,” study researcher Forest Tennant, MD, DrPH, of the Veract Intractable Pain Clinic, West Covina, California, said in a press release. “This test panel should become an indispensable tool in pain management and addiction risk assessment.”
To assess efficacy of risk assessment with a multivariant addiction panel for prescription opioid addiction, researchers used multiplexed film-based microarray technology to genotype samples for 16 nucleotide polymorphisms involved in brain reward pathways among 70 individuals diagnosed with prescription opioid or heroin addiction and 68 healthy controls. The addiction panel targeted 16 mutations, including 5-HTR2A (rs7997012), 5-HTTLPR (rS25531), COMT (rs4680), DRD2 (rs1800497), DRD1 (rs4532), DRD4 (rs3758653), DAT1 (rS6347), DBH (rs1611115), MTHFR (rs1801133), OPRK1 (rs1051660), GABA (rs211014), OPRM1 (rs1799971), MUOR (rs9479757), GAL (rs948854), DOR (rs2236861) and ATP-BCT (rs1045642). Researchers used a class prediction model building with 10-fold cross validation to test genotyping data. Risk scores ranged from 1 to 100, with a score of 52 or higher indicating increased risk for addiction.
The model had a receiver operating characteristic of 0.78 with 76% sensitivity (95% CI, 84-85) and 72% specificity (95% CI, 60-82).
Both positive and negative predictive values were 74%.
Approximately 75.7% of participants diagnosed with addiction had an addiction risk score higher than 52, compared with 27.9% of healthy controls (P < .05).
“By identifying patients with high risk to prescription opioid addiction along with mutation status of cytochrome p450 genes involved in therapeutics, it may provide information to physicians to improve therapeutic decisions in pain management and prevent abuse and addiction,” the researchers concluded. – by Amanda Oldt
Chang S, et al. Risk assessment of opioid addiction with a multi-variant genetic panel involved in the dopamine pathway. Presented at: American Association for Clinical Chemistry Annual Scientific Meeting & Clinical Lab Expo; July 30-August 3, 2017; San Diego.
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