Pharmacogenetics speeds remission
Recent randomized trials in psychiatric pharmacogenetics — including the 1,944‑patient PRIME Care trial — reported faster remission rates (31% vs. 20%) when genetics guided treatment selection. (x.com)
The VA-led pragmatic trial reporting these findings was published in JAMA in July 2022 and randomized patients within routine VA care to immediate versus delayed access to pharmacogenomic results. (jamanetwork.com) The JAMA report showed small absolute differences in PHQ‑9 remission at prespecified timepoints — 8‑week remission 14.7% vs 11.3%, 12‑week 16.5% vs 11.2%, and 24‑week 17.2% vs 16.0% — reported as the trial’s co‑primary secondary outcomes. (jamanetwork.com) Trial operations spanned 22 Department of Veterans Affairs medical centers, involved hundreds of frontline clinicians, and enrolled participants between July 2017 and February 2021 with follow‑up through November 2021, per the study protocol and trial registry. (clinicaltrials.gov) A prespecified post‑hoc time‑to‑event analysis published in Frontiers reported that pharmacogenomic‑guided care accelerated time to first remission (hazard ratio 1.27, 95% CI 1.05–1.53) and to response (HR 1.21, 95% CI 1.05–1.40), using PHQ‑9 outcomes and including 1,764 participants with sufficient visit data. (doi.org) The commercial GeneSight panel used in the trial was provided by Myriad Genetics, and Myriad scientists are among the authors of recent post‑hoc and pooled analyses that the company has cited in investor and press materials. (investor.myriad.com) Independent umbrella reviews and meta‑analyses published since the trial show mixed evidence: some pooled analyses report modest but statistically significant improvements in remission or response with PGx‑guided prescribing, while other large randomized trials and reviews conclude the benefit is inconsistent across platforms and patient populations. (frontiersin.org) (ascpt.onlinelibrary.wiley.com)
