IADR Abstract Archives
CYP3A4 Polymorphisms Correlated with Clinical Efficacy of Ibuprofen After Surgery
Objectives: This study aimed to analyze the association between polymorphisms of CYP3A4 gene, responsible for NSAIDs metabolism, and the control of postoperative inflammation symptoms, in 195 Brazilian volunteers who underwent extraction of one lower third molar and receive therapy with ibuprofen (600 mg, every 8 hours for 4 days).
Methods: Genetic sequencing of 197 DNA samples, was performed in this study, using Kailos Genetics Inc. protocol, with Illumina® MiSeq® System with 2x78bp read length, to find possible CYP3A4 polymorphisms association with postoperative pain, trismus and swelling experience when treated with ibuprofen.
Results: In this study 184 patients were found with normal metabolic activity (*1/*1) ancestral for CYP3A4 and 11 patients were mutated (*1/*22) haplotype with reduced metabolic activity. In this population, pain score at 8 hours after the surgery was reported in a visual analog scale (VAS 0 to 100mm), and was observed that 8.47±13.04 mm in VAS scale on ancestral group and 7.18±14.54 mm on mutated group (p=0.2895). The analysis of trismus was made by the percentage of mouth opening reduction on the second postoperative day regarding the preoperatory data. In the ancestral population the mean of trismus was 46.54±16.06, and in the mutated patients was 52.27±21.67 (p=0.26). Difference of swelling between the second postoperative day and preoperative day in percentage was 4.86±6.65 and 3.81±2.71 for ancestral and mutated patients, respectively (p=0.29).
Conclusions: The study of pharmacogenetic is extremely important to understand how genetic variations may influence the therapy applied to patients after dental surgery, thus avoiding over-prescription of analgesic drugs. The clinical efficacy of ibuprofen in controlling postoperative pain, edema and trismus after extraction of a lower third molar was similar in all patients evaluated regardless of the genetic mutations found in CYP3A4.
Methods: Genetic sequencing of 197 DNA samples, was performed in this study, using Kailos Genetics Inc. protocol, with Illumina® MiSeq® System with 2x78bp read length, to find possible CYP3A4 polymorphisms association with postoperative pain, trismus and swelling experience when treated with ibuprofen.
Results: In this study 184 patients were found with normal metabolic activity (*1/*1) ancestral for CYP3A4 and 11 patients were mutated (*1/*22) haplotype with reduced metabolic activity. In this population, pain score at 8 hours after the surgery was reported in a visual analog scale (VAS 0 to 100mm), and was observed that 8.47±13.04 mm in VAS scale on ancestral group and 7.18±14.54 mm on mutated group (p=0.2895). The analysis of trismus was made by the percentage of mouth opening reduction on the second postoperative day regarding the preoperatory data. In the ancestral population the mean of trismus was 46.54±16.06, and in the mutated patients was 52.27±21.67 (p=0.26). Difference of swelling between the second postoperative day and preoperative day in percentage was 4.86±6.65 and 3.81±2.71 for ancestral and mutated patients, respectively (p=0.29).
Conclusions: The study of pharmacogenetic is extremely important to understand how genetic variations may influence the therapy applied to patients after dental surgery, thus avoiding over-prescription of analgesic drugs. The clinical efficacy of ibuprofen in controlling postoperative pain, edema and trismus after extraction of a lower third molar was similar in all patients evaluated regardless of the genetic mutations found in CYP3A4.