Trial reportBritish journal of clinical pharmacology2015
CYP2B6*6 allele and age substantially reduce steady-state ketamine clearance in chronic pain patients: impact on adverse effects.
Trial report in British journal of clinical pharmacology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
30 citing papers in PubMed, 69 citations in OpenAlex.
- The role of cytochrome P450 polymorphisms in the pharmacokinetics of oral esketamine.The pharmacogenomics journal · 2026Trial
- Common Polymorphisms of CYP2B6 Influence Stereoselective Bupropion Disposition.Clinical pharmacology and therapeutics · 2019Trial
- Genome-wide screening of pharmacogenomic biomarkers in jordanian patients with genetic disorders.The pharmacogenomics journal · 2025Article
- The Role of Pharmacogenomics in Optimizing Ketamine Therapy for Post-Amputation Pain.Reports (MDPI) · 2025Review
- Genetic Variation and Sex-Based Differences: Current Considerations for Anesthetic Management.Current issues in molecular biology · 2025Review
- Ketamine - An Imperfect Wonder Drug?Biochemical pharmacology · 2024Review
- Personalized anesthesia and precision medicine: a comprehensive review of genetic factors, artificial intelligence, and patient-specific factors.Frontiers in medicine · 2024Review
- Oral ketamine may offer a solution to the ketamine conundrum.Psychopharmacology · 2023Review
- The Role of Glutamate Receptors in Epilepsy.Biomedicines · 2023Review
- Population Pharmacokinetics and Pharmacodynamics of the Therapeutic and Adverse Effects of Ketamine in Patients With Treatment-Refractory Depression.Clinical pharmacology and therapeutics · 2022Article
- The Role of Pharmacogenomics in Postoperative Pain Management.Methods in molecular biology (Clifton, N.J.) · 2022Article
- Age- and Diet-Dependent Changes in Hepatic Lipidomic Profiles of Phospholipids in Male Mice: Age Acceleration in Cyp2b-Null Mice.Journal of lipids · 2022Article
- PharmVar GeneFocus: CYP2B6.Clinical pharmacology and therapeutics · 2021Review
- A Narrative Review on Perioperative Pain Management Strategies in Enhanced Recovery Pathways-The Past, Present and Future.Journal of clinical medicine · 2021Review
- CYP2B6 Functional Variability in Drug Metabolism and Exposure Across Populations-Implication for Drug Safety, Dosing, and Individualized Therapy.Frontiers in genetics · 2021Review
- Ketamine in seizure management and future pharmacogenomic considerations.The pharmacogenomics journal · 2020Review
- Pharmacogenomics of Pain Management: The Impact of Specific Biological Polymorphisms on Drugs and Metabolism.Current oncology reports · 2020Review
- Ketamine Use for Cancer and Chronic Pain Management.Frontiers in pharmacology · 2020Review
- Pain polymorphisms and opioids: An evidence based review.Molecular medicine reports · 2019Article
- Potential role of pharmacogenomics testing in the setting of enhanced recovery pathways after surgery.Pharmacogenomics and personalized medicine · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors at 7 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsKetamine analgesia is limited by low intrinsic efficacy compounded by large interindividual variability in drug responses, possibly due to the heterogeneity in drug concentration. The CYP2B6*6 allele is associated with substantially reduced ketamine metabolism in vitro and, therefore, may affect ketamine clearance. Our aims were to examine the impact of the CYP2B6*6 allele on ketamine plasma clearance and on adverse effects in chronic pain patients.
methodsCYP2B6 genotypes were identified in 49 chronic pain patients who received 24 h continuous subcutaneous infusions of ketamine. Steady-state plasma concentrations of ketamine (Css,k ) and norketamine (Css,nk ) were determined using HPLC.
resultsThe median plasma clearance of ketamine after 100 mg 24 h(-1) dose was significantly lower in patients with the CYP2B6*6/*6 (21.6 l h(-1) ) and CYP2B6*1/*6 (40.6 l h(-1) ) genotypes compared with patients with the CYP2B6*1/*1 genotype (68.1 l h(-1) , P < 0.001). The ketamine : norketamine plasma metabolic ratio was significantly higher in patients with the CYP2B6*6/*6 genotype than in those with the CYP2B6*1/*6 and the CYP2B6*1/*1 genotypes (P < 0.001). Patients who experienced adverse effects had lower plasma clearance (45.6 l h(-1) ) than those who did not (52.6 l h(-1) , P = 0.04). The CYP2B6*6 genotype and age, and their combined impact explained 40%, 30% and 60% of the variation in Css,k , respectively. Similar results were observed after higher doses.
conclusionsThe CYP2B6*6 allele is associated with a substantial decrease in steady-state ketamine plasma clearance in chronic pain patients. The decreased clearance and resultant higher plasma concentrations may be associated with a higher incidence of ketamine adverse effects.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.