Moving toward personalized medicine in the methadone maintenance treatment program: a pilot study on the evaluation of treatment responses in Taiwan.
This pilot study simultaneously evaluated the effects of various factors, including genetic variations of CYP2B6, CYP2C19, and ABCB1, demographic characteristics, disease states, methadone-drug interactions (MDIs), and poly-substance use, on the treatment responses among non-HIV patients in the methadone maintenance treatment program (MMTP) in Taiwan. A total of 178 patients were recruited from two major hospitals that provided MMTP services in southern Taiwan, and information regarding concomitant medications and diseases was acquired from the National Health Insurance (NHI) program. The results demonstrated that the methadone maintenance dose, CYP2B6 785G allele, and ABCB1 2677T allele have positive effects on the methadone plasma concentration. In contrast, patients with HCV coinfection, alcohol problems, and psychiatric diseases may have a negative response to treatment. Thus, a comprehensive evaluation of treatment responses in the MMTP should include not only genetic polymorphisms in methadone metabolism and transporter proteins, but also concomitant diseases, MDIs, and poly-substance use. The results also suggest that personalized medicine may be indispensable for a better outcome of the MMTP.
School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, No. 100 Shih-Chuan 1st Road, Kaohsiung City 807, Taiwan.
Hsin-Ya
HY
Lee
School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, No. 100 Shih-Chuan 1st Road, Kaohsiung City 807, Taiwan ; Program in Toxicology, College of Pharmacy, Kaohsiung Medical University, No. 100 Shih-Chuan 1st Road, Kaohsiung City 807, Taiwan.
Jih-Heng
JH
Li
School of Pharmacy, College of Pharmacy, Kaohsiung Medical University, No. 100 Shih-Chuan 1st Road, Kaohsiung City 807, Taiwan.
Yuh-Ling
YL
Sheu
Department of Addiction and Forensic Psychiatry, Jianan Mental Hospital, No. 80, Lane 870, Jhong-Shan Road, Rende District, Tainan City 71742, Taiwan.
Hsin-Pei
HP
Tang
School of Pharmacy, Taipei Medical University, No. 250 Wu-Shin Street, Taipei 110, Taiwan.
Wei-Chiao
WC
Chang
Department of Psychiatry, Kaohsiung Medical University Hospital, No. 100 Shih-Chuan 1st Road, Kaohsiung City 807, Taiwan.
Tze-Chun
TC
Tang
Department of Psychiatry, Kaohsiung Medical University Hospital, No. 100 Shih-Chuan 1st Road, Kaohsiung City 807, Taiwan ; Department of Psychiatry, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, No. 100 Shih-Chuan 1st Road, Kaohsiung City 807, Taiwan.
Yi-Chun
YC
Yeh
Department of Psychiatry, Kaohsiung Medical University Hospital, No. 100 Shih-Chuan 1st Road, Kaohsiung City 807, Taiwan.
Shing-Yaw
SY
Wang
Department of Medical Technology, Fooyin University, No. 151 Ching-Hsueh Road, Kaohsiung City 831, Taiwan.
Ray-H
RH
Liu
D018435:ATP Binding Cassette Transporter, Subfamily B; D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1 / Q000235:genetics*; D000328:Adult; D000483:Alleles; D001189:Aryl Hydrocarbon Hydroxylases / Q000235:genetics*; D065702:Cytochrome P-450 CYP2B6; D065731:Cytochrome P-450 CYP2C19; D005260:Female; D015658:HIV Infections / Q000188:drug therapy; D006556:Heroin Dependence / Q000188:drug therapy* / Q000235:genetics; D006801:Humans; D008297:Male; D008691:Methadone / Q000097:blood / Q000627:therapeutic use*; D008875:Middle Aged; D058850:Opiate Substitution Treatment / Q000379:methods; D010865:Pilot Projects; D057285:Precision Medicine; D013624:Taiwan; D016896:Treatment Outcome
C513055:ABCB1 protein, human; D018435:ATP Binding Cassette Transporter, Subfamily B; D020168:ATP Binding Cassette Transporter, Subfamily B, Member 1; D001189:Aryl Hydrocarbon Hydroxylases; C585599:CYP2B6 protein, human; C045793:CYP2C19 protein, human; D065702:Cytochrome P-450 CYP2B6; D065731:Cytochrome P-450 CYP2C19; D008691:Methadone