The effects of OPRM1 118A>G on methadone response in pain management in advanced cancer at end of life.

Haupt, LM; Haywood, A; Sutherland, HG; Yu, C; Albury, CL; Pharasi, A; Zunk, M; George, R; Griffiths, LR; Good, P; Hardy, J

The effects of OPRM1 118A>G on methadone response in pain management in advanced cancer at end of life.

Haupt, LM Haywood, A Sutherland, HG Yu, C Albury, CL Pharasi, A Zunk, M George, R Griffiths, LR Good, P

Hardy, J

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Publisher:: NATURE PORTFOLIO
Publication Type:: Journal Article
Citation:: Sci Rep, 2024, 14, (1), pp. 3411
Issue Date:: 2024-02-10

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Field	Value	Language
dc.contributor.author	Haupt, LM
dc.contributor.author	Haywood, A
dc.contributor.author	Sutherland, HG
dc.contributor.author	Yu, C
dc.contributor.author	Albury, CL
dc.contributor.author	Pharasi, A
dc.contributor.author	Zunk, M
dc.contributor.author	George, R
dc.contributor.author	Griffiths, LR
dc.contributor.author	Good, P https://orcid.org/0000-0002-8198-0375
dc.contributor.author	Hardy, J
dc.date.accessioned	2024-08-01T04:39:55Z
dc.date.available	2024-02-07
dc.date.available	2024-08-01T04:39:55Z
dc.date.issued	2024-02-10
dc.identifier.citation	Sci Rep, 2024, 14, (1), pp. 3411
dc.identifier.issn	2045-2322
dc.identifier.issn	2045-2322
dc.identifier.uri	http://hdl.handle.net/10453/179953
dc.description.abstract	Cancer pain is the most feared symptom at end of life. Methadone has advantages over other opioids but is associated with significant variability in clinical response, making dosing challenging in practice. OPRM1 is the most studied pharmacogene associated with the pharmacodynamics of opioids, however reports on the association of the A118G polymorphism on opioid dose requirements are conflicting, with no reports including methadone as the primary intervention. This association study on OPRM1 A118G and response to methadone for pain management, includes a review of this genetic factor's role in inter-patient variability. Fifty-four adult patients with advanced cancer were recruited in a prospective, multi-centre, open label dose individualization study. Patient characteristics were not shown to influence methadone response, and no significant associations were observed for methadone dose or pain score. The findings of our review of association studies for OPRM1 A118G in advanced cancer pain demonstrate the importance of taking ancestry into account. While our sample size was small, our results were consistent with European populations, but in contrast to studies in Chinese patients, where carriers of the A118G polymorphism were associated with higher opioid dose requirements. Pharmacogenetic studies in palliative care are challenging, continued contribution will support future genotype-based drug dosing guidelines.
dc.format	Electronic
dc.language	eng
dc.publisher	NATURE PORTFOLIO
dc.relation.ispartof	Sci Rep
dc.relation.isbasedon	10.1038/s41598-024-54009-9
dc.rights	info:eu-repo/semantics/openAccess
dc.subject.mesh	Adult
dc.subject.mesh	Humans
dc.subject.mesh	Analgesics, Opioid
dc.subject.mesh	Cancer Pain
dc.subject.mesh	Genotype
dc.subject.mesh	Methadone
dc.subject.mesh	Neoplasms
dc.subject.mesh	Pain Management
dc.subject.mesh	Polymorphism, Single Nucleotide
dc.subject.mesh	Prospective Studies
dc.subject.mesh	Receptors, Opioid, mu
dc.subject.mesh	Humans
dc.subject.mesh	Neoplasms
dc.subject.mesh	Methadone
dc.subject.mesh	Receptors, Opioid, mu
dc.subject.mesh	Analgesics, Opioid
dc.subject.mesh	Prospective Studies
dc.subject.mesh	Genotype
dc.subject.mesh	Polymorphism, Single Nucleotide
dc.subject.mesh	Adult
dc.subject.mesh	Pain Management
dc.subject.mesh	Cancer Pain
dc.subject.mesh	Adult
dc.subject.mesh	Humans
dc.subject.mesh	Analgesics, Opioid
dc.subject.mesh	Cancer Pain
dc.subject.mesh	Genotype
dc.subject.mesh	Methadone
dc.subject.mesh	Neoplasms
dc.subject.mesh	Pain Management
dc.subject.mesh	Polymorphism, Single Nucleotide
dc.subject.mesh	Prospective Studies
dc.subject.mesh	Receptors, Opioid, mu
dc.title	The effects of OPRM1 118A>G on methadone response in pain management in advanced cancer at end of life.
dc.type	Journal Article
utslib.citation.volume	14
utslib.location.activity	England
pubs.organisational-group	University of Technology Sydney
pubs.organisational-group	University of Technology Sydney/Faculty of Health
pubs.organisational-group	University of Technology Sydney/Faculty of Health/IMPACCT
utslib.copyright.status	open_access	*
dc.rights.license	This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). To view a copy of this license, visit https://creativecommons.org/licenses/by/4.0/
dc.date.updated	2024-08-01T04:39:50Z
pubs.issue	1
pubs.publication-status	Published online
pubs.volume	14
utslib.citation.issue	1

Abstract:

Cancer pain is the most feared symptom at end of life. Methadone has advantages over other opioids but is associated with significant variability in clinical response, making dosing challenging in practice. OPRM1 is the most studied pharmacogene associated with the pharmacodynamics of opioids, however reports on the association of the A118G polymorphism on opioid dose requirements are conflicting, with no reports including methadone as the primary intervention. This association study on OPRM1 A118G and response to methadone for pain management, includes a review of this genetic factor's role in inter-patient variability. Fifty-four adult patients with advanced cancer were recruited in a prospective, multi-centre, open label dose individualization study. Patient characteristics were not shown to influence methadone response, and no significant associations were observed for methadone dose or pain score. The findings of our review of association studies for OPRM1 A118G in advanced cancer pain demonstrate the importance of taking ancestry into account. While our sample size was small, our results were consistent with European populations, but in contrast to studies in Chinese patients, where carriers of the A118G polymorphism were associated with higher opioid dose requirements. Pharmacogenetic studies in palliative care are challenging, continued contribution will support future genotype-based drug dosing guidelines.

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http://hdl.handle.net/10453/179953