IADR Abstract Archives
Ibuprofen Clinical Pharmacogenetics Associated with CYP2C9 Polymorphisms
Objectives: This study aimed to analyze the association between polymorphisms of cytochrome P450 (CYP2C9) gene responsible for NSAIDs metabolism, and the control of postoperative inflammation symptoms managed by ibuprofen (600 mg, every 8 hours for 4 days), in 196 Brazilian volunteers who underwent extraction of one lower third molar.
Methods: Genetic sequencing of 196 DNA samples, from good and poor responders, was performed in this study to find possible polymorphisms in CYP2C9 that is associated with postoperative pain experience and rescue medication consumption (acetaminophen 750mg) when treated with ibuprofen. An Illumina® MiSeq® System with 2x78bp read length was used for genetic sequencing.
Results: In this study 135 patients were found ancestral for CYP2C9 with normal metabolic activity and 61 patients mutated for CYP2C9 (*1/*2, *1/*3, *2/*2 and *2/*3) haplotypes with reduced function. In this sample set, pain relief provided by ibuprofen after the surgery was classified similarly by the patients, as "excellent, very good or good", in 94% of ancestral and 95% of mutated patients. Regarding the consumption of rescue medication, 2.66±3.11 tablets of acetaminophen were taken by ancestral and 2.29±2.62 by mutated patients (p=0.74). Pain score reported in visual analog scale (VAS 0 to 100mm) by patients at the time that first rescue medication was consumed was 16.23±18.05 mm and 12.49±14.08 mm for ancestral and mutated patients, respectively (p=0.35).
Conclusions: Despite genetic mutations in CYP2C9 gene, the clinical efficacy of ibuprofen in the control of postoperative pain after extraction of one lower third molar was similar in all patients evaluated. The study of pharmacogenetics is important in understanding how genetic variations can influence the therapy applied to patients after dental surgeries, thus avoiding the overprescription of analgesic drugs.
Methods: Genetic sequencing of 196 DNA samples, from good and poor responders, was performed in this study to find possible polymorphisms in CYP2C9 that is associated with postoperative pain experience and rescue medication consumption (acetaminophen 750mg) when treated with ibuprofen. An Illumina® MiSeq® System with 2x78bp read length was used for genetic sequencing.
Results: In this study 135 patients were found ancestral for CYP2C9 with normal metabolic activity and 61 patients mutated for CYP2C9 (*1/*2, *1/*3, *2/*2 and *2/*3) haplotypes with reduced function. In this sample set, pain relief provided by ibuprofen after the surgery was classified similarly by the patients, as "excellent, very good or good", in 94% of ancestral and 95% of mutated patients. Regarding the consumption of rescue medication, 2.66±3.11 tablets of acetaminophen were taken by ancestral and 2.29±2.62 by mutated patients (p=0.74). Pain score reported in visual analog scale (VAS 0 to 100mm) by patients at the time that first rescue medication was consumed was 16.23±18.05 mm and 12.49±14.08 mm for ancestral and mutated patients, respectively (p=0.35).
Conclusions: Despite genetic mutations in CYP2C9 gene, the clinical efficacy of ibuprofen in the control of postoperative pain after extraction of one lower third molar was similar in all patients evaluated. The study of pharmacogenetics is important in understanding how genetic variations can influence the therapy applied to patients after dental surgeries, thus avoiding the overprescription of analgesic drugs.