title: Genetic polymorphisms and response to medications for alcohol use disorders: a systematic review and meta-analysis.
abstract: OBJECTIVE
  To assess whether response to medications for alcohol use disorders varies by genotype.
  
  
  METHODS
  Systematic review and meta-analysis.
  
  
  RESULTS
  We found no studies that assessed the clinical utility of genotype-guided dosing strategies or genotype-guided medication selection, and none randomized by genotype. All included studies assessed the association between genotype and response to medication. Of 15 included studies, eight (n = 1365 participants) assessed variation in naltrexone response and polymorphisms of OPRM1. Our meta-analyses for return to heavy drinking found no significant difference between A allele homozygotes and those with at least one G allele, both without (risk difference: 0.26; 95% CI: -0.01-0.53; n = 174) and with inclusion of studies rated as high or unclear risk of bias (risk difference: 0.14; 95% CI: -0.03-0.3; n = 382). For all other polymorphism-medication pairs, we found just one eligible study.
  
  
  CONCLUSIONS
  Estimates of effect for return to heavy drinking suggest it is possible that patients with at least one G allele of A118G polymorphism of OPRM1 might be more likely to respond to naltrexone, but confidence intervals were wide; additional studies are needed to improve confidence in the estimates.
authors.affiliation: University of North Carolina at Chapel Hill, Department of Medicine, 5034 Old Clinic Building, CB #7110, Chapel Hill, NC 27599, USA.
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Jonas
authors.forename: Halle R
authors.initials: HR
authors.lastname: Amick
authors.forename: Cynthia
authors.initials: C
authors.lastname: Feltner
authors.forename: Roberta
authors.initials: R
authors.lastname: Wines
authors.forename: Ellen
authors.initials: E
authors.lastname: Shanahan
authors.forename: Cassandra J
authors.initials: CJ
authors.lastname: Rowe
authors.forename: James C
authors.initials: JC
authors.lastname: Garbutt
mesh_terms: D020751:Alcohol-Induced Disorders / Q000188:drug therapy / Q000235:genetics*; D005838:Genotype; D006801:Humans; D009271:Naltrexone / Q000627:therapeutic use; D011110:Polymorphism, Genetic; D017450:Receptors, Opioid, mu / Q000235:genetics
chemical_list: C485764:OPRM1 protein, human; D017450:Receptors, Opioid, mu; D009271:Naltrexone
keywords: OPRM1; alcohol; alcohol dependence; alcohol use disorder; naltrexone; opioid receptor; pharmacogenomics; polymorphism; systematic review