Exploring Biologic Predictors Response Disparities to Atypical Antipsychotics among Blacks: A Quasi-Systematic Review.
Ethn Dis
; 30(Suppl 1): 229-240, 2020.
Article
en En
| MEDLINE
| ID: mdl-32269465
ABSTRACT
Purpose:
Management of schizophrenia among Blacks in the United States is affected by persistent disparities. This review explored response to atypical antipsychotics among Blacks compared with other groups to assess systematic variation that may contribute to disparities.Methods:
We conducted a quasi-systematic review of studies reporting response to atypical antipsychotics among Blacks compared with other groups, including effects of genetic variation.Results:
Of 48 identified research articles, 29 assessed differences in outcomes without inclusion of genetic variation and 20 explored effects of genetic variation; of note one article included both types of data. Analysis of the 29 papers with clinical outcomes only suggests that while data on efficacy and risk of movement disorders were heterogeneous, findings indicate increased risk of metabolic effects and neutropenia among Blacks. Of the 20 articles exploring effects of genetic variation, allelic or genotypic variations involving several genes were associated with altered efficacy or safety among Blacks but not Whites, including risk of decreased response involving variation in DRD4 and DRD1, and improved efficacy associated with variants in DRD2, COMT, and RGS4. Others showed significant improvement in treatment response only among Whites, including variation in DTNBP1, DRD4, and GNB3.Conclusions:
The current analysis can help tailor management among Blacks using an atypical antipsychotic. Heterogeneity in genetic variation effects and response allele frequency suggests that pharmacogenetics approaches for atypical antipsychotics will need to explicitly incorporate race and ethnicity.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Contexto en salud:
1_ASSA2030
/
2_ODS3
Problema de salud:
1_acesso_equitativo_servicos
/
2_cobertura_universal
Asunto principal:
Esquizofrenia
/
Antipsicóticos
/
Negro o Afroamericano
/
Disparidades en el Estado de Salud
Tipo de estudio:
Prognostic_studies
/
Risk_factors_studies
/
Systematic_reviews
Aspecto:
Determinantes_sociais_saude
/
Equity_inequality
/
Patient_preference
Límite:
Humans
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Ethn Dis
Asunto de la revista:
CIENCIAS SOCIAIS
/
SAUDE PUBLICA
Año:
2020
Tipo del documento:
Article
País de afiliación:
Túnez