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Genetic predictors of response to serotonergic and noradrenergic antidepressants in major depressive disorder: a genome-wide analysis of individual-level data and a meta-analysis.

Tansey KE, Guipponi M, Perroud N, Bondolfi G, Domenici E, Evans D, Hall SK, Hauser J, Henigsberg N, Hu X, Jerman B, Maier W, Mors O, O'Donovan M, Peters TJ, Placentino A, Rietschel M, Souery D, Aitchison KJ, Craig I, Farmer A, Wendland JR, Malafosse A, Holmans P, Lewis G, Lewis CM, Stensbøl TB, Kapur S, McGuffin P, Uher R - PLoS Med. (2012)

Bottom Line: No biological pathways were significantly overrepresented in the results.Polygenic scoring found no convergence among multiple associations in NEWMEDS and STAR*D.No single common genetic variant was associated with antidepressant response at a clinically relevant level in a European-ancestry cohort.

View Article: PubMed Central - PubMed

Affiliation: Institute of Psychiatry, King's College London, London, UK.

ABSTRACT

Background: It has been suggested that outcomes of antidepressant treatment for major depressive disorder could be significantly improved if treatment choice is informed by genetic data. This study aims to test the hypothesis that common genetic variants can predict response to antidepressants in a clinically meaningful way.

Methods and findings: The NEWMEDS consortium, an academia-industry partnership, assembled a database of over 2,000 European-ancestry individuals with major depressive disorder, prospectively measured treatment outcomes with serotonin reuptake inhibiting or noradrenaline reuptake inhibiting antidepressants and available genetic samples from five studies (three randomized controlled trials, one part-randomized controlled trial, and one treatment cohort study). After quality control, a dataset of 1,790 individuals with high-quality genome-wide genotyping provided adequate power to test the hypotheses that antidepressant response or a clinically significant differential response to the two classes of antidepressants could be predicted from a single common genetic polymorphism. None of the more than half million genetic markers significantly predicted response to antidepressants overall, serotonin reuptake inhibitors, or noradrenaline reuptake inhibitors, or differential response to the two types of antidepressants (genome-wide significance p<5×10(-8)). No biological pathways were significantly overrepresented in the results. No significant associations (genome-wide significance p<5×10(-8)) were detected in a meta-analysis of NEWMEDS and another large sample (STAR*D), with 2,897 individuals in total. Polygenic scoring found no convergence among multiple associations in NEWMEDS and STAR*D.

Conclusions: No single common genetic variant was associated with antidepressant response at a clinically relevant level in a European-ancestry cohort. Effects specific to particular antidepressant drugs could not be investigated in the current study. Please see later in the article for the Editors' Summary.

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Related in: MedlinePlus

Quantile–quantile plots for the four genome-wide analyses.(A) Analysis of the whole sample (n = 1,790); (B) analysis of SRI-treated individuals (n = 1,222); (C) analysis of NRI-treated individuals (n = 568); (D) gene-by-drug interaction analysis in the randomly allocated individuals (n = 949). The shaded area is the 95% confidence interval of values expected under a uniform distribution.
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pmed-1001326-g002: Quantile–quantile plots for the four genome-wide analyses.(A) Analysis of the whole sample (n = 1,790); (B) analysis of SRI-treated individuals (n = 1,222); (C) analysis of NRI-treated individuals (n = 568); (D) gene-by-drug interaction analysis in the randomly allocated individuals (n = 949). The shaded area is the 95% confidence interval of values expected under a uniform distribution.

Mentions: Linear regression assessed the influence of 520,978 SNPs on the adjusted percentage change in depression severity in the whole sample of 1,790 antidepressant-treated individuals. A quantile–quantile plot showed a uniform distribution of p-values, with no inflation of the test statistic (median lambda = 1.0034; Figure 2). No association reached the genome-wide level of significance (Figure 3).


Genetic predictors of response to serotonergic and noradrenergic antidepressants in major depressive disorder: a genome-wide analysis of individual-level data and a meta-analysis.

Tansey KE, Guipponi M, Perroud N, Bondolfi G, Domenici E, Evans D, Hall SK, Hauser J, Henigsberg N, Hu X, Jerman B, Maier W, Mors O, O'Donovan M, Peters TJ, Placentino A, Rietschel M, Souery D, Aitchison KJ, Craig I, Farmer A, Wendland JR, Malafosse A, Holmans P, Lewis G, Lewis CM, Stensbøl TB, Kapur S, McGuffin P, Uher R - PLoS Med. (2012)

Quantile–quantile plots for the four genome-wide analyses.(A) Analysis of the whole sample (n = 1,790); (B) analysis of SRI-treated individuals (n = 1,222); (C) analysis of NRI-treated individuals (n = 568); (D) gene-by-drug interaction analysis in the randomly allocated individuals (n = 949). The shaded area is the 95% confidence interval of values expected under a uniform distribution.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3472989&req=5

pmed-1001326-g002: Quantile–quantile plots for the four genome-wide analyses.(A) Analysis of the whole sample (n = 1,790); (B) analysis of SRI-treated individuals (n = 1,222); (C) analysis of NRI-treated individuals (n = 568); (D) gene-by-drug interaction analysis in the randomly allocated individuals (n = 949). The shaded area is the 95% confidence interval of values expected under a uniform distribution.
Mentions: Linear regression assessed the influence of 520,978 SNPs on the adjusted percentage change in depression severity in the whole sample of 1,790 antidepressant-treated individuals. A quantile–quantile plot showed a uniform distribution of p-values, with no inflation of the test statistic (median lambda = 1.0034; Figure 2). No association reached the genome-wide level of significance (Figure 3).

Bottom Line: No biological pathways were significantly overrepresented in the results.Polygenic scoring found no convergence among multiple associations in NEWMEDS and STAR*D.No single common genetic variant was associated with antidepressant response at a clinically relevant level in a European-ancestry cohort.

View Article: PubMed Central - PubMed

Affiliation: Institute of Psychiatry, King's College London, London, UK.

ABSTRACT

Background: It has been suggested that outcomes of antidepressant treatment for major depressive disorder could be significantly improved if treatment choice is informed by genetic data. This study aims to test the hypothesis that common genetic variants can predict response to antidepressants in a clinically meaningful way.

Methods and findings: The NEWMEDS consortium, an academia-industry partnership, assembled a database of over 2,000 European-ancestry individuals with major depressive disorder, prospectively measured treatment outcomes with serotonin reuptake inhibiting or noradrenaline reuptake inhibiting antidepressants and available genetic samples from five studies (three randomized controlled trials, one part-randomized controlled trial, and one treatment cohort study). After quality control, a dataset of 1,790 individuals with high-quality genome-wide genotyping provided adequate power to test the hypotheses that antidepressant response or a clinically significant differential response to the two classes of antidepressants could be predicted from a single common genetic polymorphism. None of the more than half million genetic markers significantly predicted response to antidepressants overall, serotonin reuptake inhibitors, or noradrenaline reuptake inhibitors, or differential response to the two types of antidepressants (genome-wide significance p<5×10(-8)). No biological pathways were significantly overrepresented in the results. No significant associations (genome-wide significance p<5×10(-8)) were detected in a meta-analysis of NEWMEDS and another large sample (STAR*D), with 2,897 individuals in total. Polygenic scoring found no convergence among multiple associations in NEWMEDS and STAR*D.

Conclusions: No single common genetic variant was associated with antidepressant response at a clinically relevant level in a European-ancestry cohort. Effects specific to particular antidepressant drugs could not be investigated in the current study. Please see later in the article for the Editors' Summary.

Show MeSH
Related in: MedlinePlus