International Journal of Molecular Medical Science, 2024, Vol.14, No.4, 216-226 http://medscipublisher.com/index.php/ijmms 220 Figure 2 Patient outcomes at week 8 in the pharmacogenomics guided-care arm (n = 560) compared to treatment as usual (n = 607) (Adopted from Greden et al., 2019) Image caption: Outcomes were evaluated using the HAM-D17 depression rating scales (Adopted from Greden et al., 2019) 4 Impact of Genomics on Treatment Outcomes 4.1 Efficacy of personalized treatments The comparative effectiveness of personalized treatments versus standard treatments has been a focal point in recent research. Pharmacogenomics, which tailors medication based on genetic profiles, has shown promise in improving treatment outcomes for major depressive disorder (MDD). For instance, the GUIDED trial demonstrated that while symptom improvement was not significantly different between pharmacogenomics-guided care and treatment as usual (TAU), there were significant improvements in response and remission rates for patients receiving guided care (Greden et al., 2019). Similarly, a meta-analysis of randomized controlled trials (RCTs) found that pharmacogenomics-guided treatment was superior to TAU in terms of response and remission rates for treatment-resistant depression (TRD) (Cheng et al., 2023) (Figure 3). These findings suggest that personalized treatments can offer substantial benefits over standard approaches, particularly for patients who have not responded to initial treatments. Clinical trials have provided concrete examples of the efficacy of personalized treatments. In the IMPACT study, patients with MDD who received combinatorial pharmacogenomic testing showed significant improvements in symptom reduction, response, and remission rates compared to those who did not receive such testing (Tanner et al., 2018). Another study highlighted that patients taking medications congruent with their genetic profiles experienced better outcomes than those on incongruent medications (Thase et al., 2019). These trials underscore the potential of personalized medicine to enhance treatment efficacy by aligning medication choices with individual genetic profiles. 4.2 Patient adherence and satisfaction Patient adherence and satisfaction are critical components of successful treatment outcomes. Pharmacogenomics-guided treatments have been shown to positively impact these factors. For example, a meta-analysis revealed that while the acceptability and side effect burden of pharmacogenomics-guided treatments were not significantly different from TAU, the guided treatments did show a trend towards better patient adherence (Cheng et al., 2023). This suggests that personalized treatments may enhance patient satisfaction by reducing the trial-and-error process often associated with standard treatments. Qualitative studies and patient feedback further illuminate the benefits of personalized treatments. Patients often report higher satisfaction levels when their treatment plans are tailored to their genetic profiles. In the GUIDED trial, patients who switched from incongruent to congruent medications reported greater symptom improvement and higher satisfaction with their treatment (Greden et al., 2019). These qualitative insights highlight the importance of considering patient experiences and preferences in the development of personalized treatment plans.
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