Welcome to our new podcast! In this speedy episode, guided by Dr. Joshua Goldenberg, we explore the impact of pharmacogenetic testing on major depressive disorder treatment. The recently published Prime Study investigates whether these tests genuinely enhance remission rates, offering hope for those facing depression. Join us for a rapid journey through surprising outcomes, examining how genetic testing influences clinical decisions and its profound implications for patient care. Gain quick insights into depression treatment and the evolving role of genetic testing in personalized medicine. This is a brief but impactful discussion shaping our swift approach to mental health challenges.
Welcome to our new podcast! In this speedy episode, guided by Dr. Joshua Goldenberg, we explore the impact of pharmacogenetic testing on major depressive disorder treatment. The recently published Prime Study investigates whether these tests genuinely enhance remission rates, offering hope for those facing depression. Join us for a rapid journey through surprising outcomes, examining how genetic testing influences clinical decisions and its profound implications for patient care. Gain quick insights into depression treatment and the evolving role of genetic testing in personalized medicine. This is a brief but impactful discussion shaping our swift approach to mental health challenges.
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Introducer:
Welcome to the Dr Journal Club podcast, the show that goes onto the hood of evidence-based integrative medicine. We review recent research articles, interview evidence-based medicine thought leaders and discuss the challenges and opportunities of integrating evidence-based and integrative medicine. Continue your learning after the show at www. dr journalclub. com.
Josh:
Please bear in mind that this is for educational and entertainment purposes only. Talk to your doctor before making any medical decisions, changes, etc. Everything we're talking about that's to teach you guys stuff and have fun. We are not your doctors. Also, we would love to answer your specific questions. On www. dr journalclub. com you can post questions and comments for specific videos, but go ahead and email us directly at josh at drjournalclub. com. That's josh at drjournalclub. com. Send us your listener questions and we will discuss it on our pod. Hello and welcome to another super speedy summary. This is your host, dr Joshua Goldenberg, and today we're going to be talking about the Prime Study.
Josh:
Now, this is a recent paper that just came out in JAMA on a very interesting topic. So the problem is for many of you who are doing primary care or working with patients with depression depression is really hard to treat and there are many different pharmaceutical therapeutic options out there and they're not all great, and often it takes a while to find the right one for the right patient and often it's a matter of, you know, empiric trials of this drug. If that doesn't work, that drug, etc. In fact, remission rates of depression with initial treatment is only about 30%. Now in that context, there's been sort of an explosion of marketing on pharmacogenetic testing, where you give you know, you give your patients some genetic testing and then it basically runs them against all the different pharmaceutical anti-depressant options to see which is least likely to cause an adverse event. And the idea is that if you can select better based on this testing, you're going to have your less likely to cause an adverse event, you're going to be more likely to be successful and, in theory, impacting remission rates. And that was the question of this study. Would the use of pharmacogenetic testing A inform the intervention choice of the clinician? B, would that choice lead to less drugs with theoretical drug gene interaction prescriptions? And then, c, would that lead, of course the most important question to better clinical outcomes, in other words, higher rates of remission in patients with depression? So this is a massive randomized controlled trial almost 2000 patients with major depressive disorder who were either initiating or switching a single anti-depressant medication, and basically what would happen is all 2000 of these patients were given pharmacogenetic testing, the results of which were made available to the clinicians before treatment choice. In half the group and the other half got their results after a delay, 24 weeks later. In other words, everybody got their results. But one group had that information available to them and the thought was you know, would that inform treatment choice and therefore remission rates? And so the outcomes are the number of prescriptions with potential drug gene interactions, sort of these adverse event potentials, and then, of course, more importantly, remission rates across the two groups. So this is what they found. So indeed, the testing impacted the clinician's prescribing choices, right. So it changed what clinicians were prescribing and it led to fewer prescriptions with theoretical drug gene interactions. However, when we're looking at actual remission rates up to 24 weeks, which was the endpoint of the study, you did see an improved remission rate in those people who had access to those drug gene interactions, or the pharmacogenetic testing odds ratio of 1.28, that was statistically significant, but at the 24 week mark that difference between groups was no longer significant. So this is a very important study, I think, with some pretty important clinical impacts.
Josh:
Go ahead and watch the basic and also in depth level videos that our very own Dr Adam Sodowski put together for this month's release Enjoy. If you enjoy this podcast, chances are that one of your colleagues and friends probably would as well. Please do us a favor and let them know about the podcast and if you have a little bit of extra time, even just a few seconds, if you could rate us and review us on Apple Podcast or any other distributor, it would be greatly appreciated. It would mean a lot to us and help get the word out to other people that would really enjoy our content. Thank you, hey y'all.
Josh:
This is Josh. You know we talked about some really interesting stuff today. I think one of the things we're gonna do that's relevant. There is a course we have on Dr Journal Club called the EBM Boot Camp. That's really meant for clinicians to sort of help them understand how to critically evaluate the literature, etc. Some of the things that we've been talking about today. Go ahead and check out the show notes link. We're gonna link to it directly. I think it might be of interest. Don't forget to follow us on social and interact with us on social media at Dr Journal Club DR Journal Club on Twitter, we're on Facebook, we're on LinkedIn, etc. Etc. So please reach out to us. We always love to talk to our fans and our listeners. If you have any specific questions you like to ask us about research, evidence, being a clinician, etc. Don't hesitate to ask and then, of course, if you have any topics that you'd like us to cover on the pod, please let us know as well.
Introducer:
Thank you for listening to the Dr Journal Club podcast, the show that goes under the hood of evidence-based integrative medicine. We review recent research articles, interview evidence-based medicine thought leaders and discuss the challenges and opportunities of integrating evidence-based and integrative medicine. Be sure to visit www. drjournalclub. com to learn more.