Key result
CYP2D6 poor metabolizers treated with metoprolol had a greater reduction in heart rate (3 beats/min, P=0.017) and blood pressure (3 mmHg, P=0.0048) compared to non-poor metabolizers.
Why the study?
CYP2D6 genetic polymorphisms affect metoprolol pharmacokinetics, but whether they also influence the clinical response to metoprolol remains uncertain.
Does CYP2D6 poor metabolizer phenotype increase heart rate and blood pressure reduction in patients treated with metoprolol?
Meta-Analysis (n=1,146)
Does CYP2D6 poor metabolizer phenotype increase heart rate and blood pressure reduction in patients treated with metoprolol?
Effect estimate: Mean difference 3 beats/min
p-value: p=0.017
CYP2D6 poor metabolizers experience greater reductions in heart rate and blood pressure and may be at higher risk of bradycardia when treated with metoprolol.
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CYP2D6 poor metabolizers may face higher bradycardia risk on metoprolol; extends pharmacogenetic evidence but needs prospective trials before guiding therapy.
Meloche et al. (2020) conducted a meta-analysis in Patients treated with metoprolol (n=1,146). CYP2D6 poor metabolizer (PM) phenotype vs. Non-PM individuals (active CYP2D6 phenotypes) was evaluated on Heart rate (HR) reduction (Mean difference 3 beats/min, p=0.017). CYP2D6 poor metabolizers treated with metoprolol had a greater reduction in heart rate (3 beats/min, P=0.017) and blood pressure (3 mmHg, P=0.0048) compared to non-poor metabolizers.
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