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Payer News
May 2020
 

Meta-analysis demonstrates significantly improved patient outcomes in major depressive disorder (MDD)

GeneSight® cohort outperforms treatment-as-usual (TAU) cohort in every endpoint

The clinical utility of combinatorial pharmacogenomic testing for patients with depression: a meta-analysis1 combined four two-arm studies2-6 evaluating whether pharmacogenomic intervention improved patient outcomes. The GeneSight cohort had significant results in every category compared to the treatment-as-usual group, despite both arms actively taking medication for MDD.

  • Symptom improvement Δ=10.08%, 95% CI=1.67-18.50, p=0.019;
  • Response RR=1.40, 95% CI=1.17-1.67, p<0.001;
  • Remission RR=1.49, 95% CI=1.17-1.89, p=0.001.

The importance of meta-analyses has been recognized by evidence frameworks such as the Grading of Recommendations Assessment, Development, and Evaluations (GRADE); the Canadian Network for Mood and Anxiety Treatments (CANMAT); and the Agency for Healthcare Research and Quality (AHRQ).7-10

"Systemic reviews or meta-analyses of randomized controlled trials (RCTs) and evidence-based clinical practice guidelines are considered to be the strongest level of evidence upon which to guide practice decisions."11

GeneSight: Information for Insurance Providers

References

1Brown L, et al. The clinical utility of combinatorial pharmacogenomic testing for patients with depression: a meta-analysis. Pharmacogenomics, published online ahead of print: 17 Apr 2020, https://doi.org/10.2217/pgs-2019-0157.

2Greden JF, et al. Impact of pharmacogenomics on clinical outcomes in major depressive disorder in the GUIDED trial: a large, patient- and rater-blinded, randomized, controlled study. J Psychiatr Res 2019 Apr; 111:59-67.

3Winner JG, et al. A prospective, randomized, double-blind study assessing the clinical impact of integrated pharmacogenomic testing for major depressive disorder. Discov Med 2013 Nov; 16(89):219-27.

4Hall-Flavin DK, et al. Utility of integrated pharmacogenomic testing to support the treatment of major depressive disorder in a psychiatric outpatient setting. Pharmacogenet Genomics 2013 Oct; 23(10): 535-48.

5Hall-Flavin DK, et al. Using a pharmacogenomic algorithm to guide the treatment of depression. Transl Psychiatry 2012 Oct; 2(10):e172.

6Altar CA, et al. Clinical utility of combinatorial pharmacogenomics-guided antidepressant therapy: evidence from three clinical studies. Mol Neuropsychiatry 2015; 1:125-55.

7GRADE working group, https://www.gradeworkinggroup.org/.

8Canadian Network for Mood and Anxiety Treatments (CANMAT), https://www.canmat.org/.

9Agency for Healthcare Research and Quality (AHRQ), https://www.ahrq.gov/.

10St. Clair J. “A new model of tracheostomy care: closing the research-practice gap. In Advances in patient safety: from research to implementation (volume 3 Implementation issues), edited by Henriksen K, Battles JB, Marks ES, et al. Rockville (MD) 2005 Feb.

11Melnyk BM, et al. Integrating levels of evidence into clinical decision making. Pediatric nursing; Pitman July/Aug 2004; 30(4):323-5.

Myriad, the Myriad logo, and GeneSight are either trademarks or registered trademarks of Myriad Genetics, Inc. in the United States and other jurisdictions. ©2020 Myriad Genetic Laboratories, Inc.

     
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