Association of MDR1 , CYP2D6 , and CYP2C19 gene polymorphisms with prophylactic migraine treatment response

Atasayar, Gülfer; Eryılmaz, Işıl Ezgi; Karlı, Necdet; Egelí, Ünal; Zarifoğlu, Mehmet; Çeçener, Gülşah; Taşkapılıoğlu, Özlem; Tunca, Berrin; Yildirim, Oznur; Ak, Seçil; Tezcan, Gülçin; Can, Fatma Ezgi

doi:10.1016/j.jns.2016.05.019

Cited by 8 publications

(8 citation statements)

References 22 publications

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“…Of nonfunctional alleles, a low frequency of CYP2D6 *7 was only observed in Turkey,[3640] CYP2D6 *14 in Saudi Arabia,[13] and CYP2D6 *3 in Iran[26] and Turkey. [333442434445] Furthermore, CYP2D6 *5 and CYP2D6 *6 showed the highest frequency in the Iranian[25] and Turkish[3036404345] populations, respectively. The CYP2D6 *4 allele had the highest frequency of 28.05% in Egypt[18192021] and the lowest frequency of 3.5% in Saudi Arabia[14] (3.5%).…”

Section: Distribution Of the Cytochrome P450 2d6 Allelic Frequencies mentioning

confidence: 99%

“…We searched in PubMed and Google Scholar from 1996 to 2017 using the combination of keywords such as CYP2D6 , allele, and frequency plus the name of each country in the Middle East region. All studies reported CYP2D6 allele and genotype frequencies in different Middle Eastern countries including Saudi Arabia,[1314] Egypt,[15161718192021] United Arab Emirates (UAE),[2223] Iran,[24252627] Jordan,[28] Syria,[29] and Turkey[30313233343536373839404142434445] performed on healthy unrelated controls or patient samples were reviewed in this article. Overview of the studies evaluated in this review is listed in Table 1, showing the number of studies in each geographic region, number and type of samples (healthy or patients), list of alleles considered, and their frequency in each study.…”

Section: Introductionmentioning

confidence: 99%

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Distribution of CYP2D6 polymorphism in the Middle Eastern region

et al. 2019

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Cytochrome P450 2D6 (CYP2D6) is an important drug-metabolizing enzyme involved in the pharmacokinetic metabolism of drugs. CYP2D6 gene is highly polymorphic, and the combination of its different alleles yields different phenotypes including extensive metabolizer (EM), intermediate metabolizer (IM), poor metabolizer (PM), and ultrarapid metabolizer (UM). Genotyping of the important alleles for this gene in different ethnicities is of particular importance for assessing the efficacy of various drugs. In this study, we reviewed the CYP2D6 allele and phenotype frequencies predicted from the genotypes of CYP2D6 in the Middle East area. Regardless of different ethnicities, the CYP2D6 *41 allele frequency was shown to be higher than that of other reduced functional alleles. In addition, CYP2D6 *4 was the most frequent nonfunctional allele in all studied populations in the Middle East. Taken together, our findings illustrated that the frequencies of PM or IM alleles and different genotypes harboring these alleles are relatively high in the Middle Eastern countries. Therefore, the study of CYP2D6 alleles for each patient to detect those that are at risk is of great importance to prevent adverse drug reactions through individualization therapy.

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Section: Distribution Of the Cytochrome P450 2d6 Allelic Frequencies mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Distribution of CYP2D6 polymorphism in the Middle Eastern region

et al. 2019

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“…The results suggest that migraine patients who receive topiramate prophylactic treatment should be assessed for the presence of the MDR1 C3435T polymorphism. However, there was no significant relationship between the treatment response to topiramate and either the CYP2D6 or CYP2C19 polymorphism, and there were no significant correlation between the treatment responses to amitriptyline, propranolol, and valproate and the MDR1, CYP2D6 and CYP2C19 gene polymorphisms (12). In one study, no significant or nominal association with genetic load was found for any of the prophylactic treatments, either in combination or separately (13).…”

Section: Discussionmentioning

confidence: 91%

The effect of gender differences on the use of valproic acid for migraine prophylaxis

Tepe

2021

Journal of Health Sciences and Medicine

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Aim:The efficacy of the drugs used for migraine prophylaxis remains unclear. At our headache polyclinic, when we observed the difference in prophylactic response especially in valproic acid (VA) treatment between genders, the response of male was found to be better than that of females so we wanted to document this difference by collecting data retrospectively Material and Method: Forty-six chronic migraine without aura patients with VA who were enrolled in our headache outpatient clinic between 2015-2018 were included in the study (29 male, 17 female). In these patients, after VA the frequency of montly attacks between sexes, changes in visual analogue scale (VAS) scores, single VA prophylaxis and the addition of a second prophylaxis drug were evaluated.Results: None of the men needed an additional second drug while 11 of 17 women needed the addition of a second drug. There was no gender difference in monthly attack frequency before treatment, whereas monthly attack frequency after treatment with VA was found to be significantly lower in men (before treatment; female 20.9±11.3 male 17.7±11.5, p>0.05) (after treatment; male 1.2±5.5 female 12.0±12.2, p<0.05). There was no difference between sexes in the pre-treatment VAS scores, but the VAS score was significantly lower in men after treatment with VA (before treatment; female 7.8±0.8 male 8.1±1.2, p>0.05)(after treatment; female 4.4±2.8 male 2.3±2.8, p<0.05). 75.9% of men had no post-treatment migraine attacks, while this rate was 5.9% in women (p<0.05). The dose range of VA treatment wasn't found to be different between genders. Conclusion:Better response of men with migraine to valproic acid treatment is important in clinical practice, and the reason for this situation may be clarified with further studies.

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“…Valproate sodium, topiramate, phenytoin, and carbamazepine (CBZ) are used to treat migraine ( Christensen et al, 2016 ; Atasayar et al, 2016 ; Fricke-Galindo et al, 2018a ). Topiramate is also efficacious in cluster headache and may have some effect in migraine with medication overuse ( Diener et al, 2007 ; Silberstein et al, 2007 ; Diener et al, 2009 ; Steiner et al, 2019 ) ( Table 2 ).…”

Section: Pharmacogenetics Of Important Drugs Used In Migraine Tension...mentioning

confidence: 99%

Pharmacogenetics in Primary Headache Disorders

et al. 2022

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Primary headache disorders, such as migraine, tension-type headache (TTH), and cluster headache, belong to the most common neurological disorders affecting a high percentage of people worldwide. Headache induces a high burden for the affected individuals on the personal level, with a strong impact on life quality, daily life management, and causes immense costs for the healthcare systems. Although a relatively broad spectrum of different pharmacological classes for the treatment of headache disorders are available, treatment effectiveness is often limited by high variances in therapy responses. Genetic variants can influence the individual treatment success by influencing pharmacokinetics or pharmacodynamics of the therapeutic as investigated in the research field of pharmacogenetics. This review summarizes the current knowledge on important primary headache disorders, including migraine, TTH, and cluster headache. We also summarize current acute and preventive treatment options for the three headache disorders based on drug classes and compounds taking important therapy guidelines into consideration. Importantly, the work summarizes and discusses the role of genetic polymorphisms regarding their impact on metabolism safety and the effect of therapeutics that are used to treat migraine, cluster headache, and TTH exploring drug classes such as nonsteroidal anti-inflammatory drugs, triptans, antidepressants, anticonvulsants, calcium channel blockers, drugs with effect on the renin–angiotensin system, and novel headache therapeutics such as ditans, anti-calcitonin-gene-related peptide antibodies, and gepants. Genetic variants in important phase I-, II-, and III-associated genes such as cytochrome P450 genes, UGT genes, and different transporter genes are scrutinized as well as variants in genes important for pharmacodynamics and several functions outside the pharmacokinetic and pharmacodynamic spectrum. Finally, the article evaluates the potential and limitations of pharmacogenetic approaches for individual therapy adjustments in headache disorders.

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Association of MDR1 , CYP2D6 , and CYP2C19 gene polymorphisms with prophylactic migraine treatment response

Cited by 8 publications

References 22 publications

Distribution of CYP2D6 polymorphism in the Middle Eastern region

Distribution of CYP2D6 polymorphism in the Middle Eastern region

The effect of gender differences on the use of valproic acid for migraine prophylaxis

Pharmacogenetics in Primary Headache Disorders

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