ArticlePediatrics2016
Pharmacogenetics for Safe Codeine Use in Sickle Cell Disease.
Article in Pediatrics, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 1 of them a synthesis that pooled it.
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
48 citing papers in PubMed, 1 synthesis or guideline pooled it, 89 citations in OpenAlex.
- Clinical Pharmacogenetics Implementation Consortium Guideline for CYP2D6, OPRM1, and COMT Genotypes and Select Opioid Therapy.Clinical pharmacology and therapeutics · 2021Guideline
- Population Pharmacokinetic Quantification of CYP2D6 Activity in Codeine Metabolism in Ambulatory Surgical Patients for Model-Informed Precision Dosing.Clinical pharmacokinetics · 2024Trial
- Drug-gene and drug-drug interactions associated with tramadol and codeine therapy in the INGENIOUS trial.Pharmacogenomics · 2019Trial
- Trial
- Pharmacogenomics and Opioid Efficacy in Sickle Cell Disease: Is the Field Ready for Precision Prescribing?Journal of personalized medicine · 2026Review
- Pharmacogenomics and Opioid Efficacy in Sickle Cell Disease.Medicina (Kaunas, Lithuania) · 2026Review
- Results of the ACCOuNT Trial: A Multi-Institutional Prospective Pharmacogenomics Implementation Trial for African American Inpatients.Clinical pharmacology and therapeutics · 2026Observational
- Utilisation of drugs with pharmacogenetic recommendations in children in Switzerland.The pharmacogenomics journal · 2025Article
- Care Team Attributes Predict Likelihood of Utilizing Pharmacogenomic Information During Inpatient Prescribing.Clinical and translational science · 2025Observational
- CYP2D6 Pharmacogenetics in Nigerian Sickle Cell Disease: Phase 1 of Implementing Pharmacogenomics Testing for Effective Care and Treatment in Africa (iPROTECTA) program.Gates open research · 2025Article
- Implementing a pragmatic clinical trial to tailor opioids for chronic pain on behalf of the IGNITE ADOPT PGx investigators.Clinical and translational science · 2024Article
- Pharmacogenomics of Drugs Used in β-Thalassemia and Sickle-Cell Disease: From Basic Research to Clinical Applications.International journal of molecular sciences · 2024Review
- Review
- Identification of Drugs Acting as Perpetrators in Common Drug Interactions in a Cohort of Geriatric Patients from Southern Italy and Analysis of the Gene Polymorphisms That Affect Their Interacting Potential.Geriatrics (Basel, Switzerland) · 2023Article
- Practice of CYP450 genotyping and phenotyping in children in a real-life setting.Frontiers in pharmacology · 2023Article
- Clinician adherence to pharmacogenomics prescribing recommendations in clinical decision support alerts.Journal of the American Medical Informatics Association : JAMIA · 2022Article
- Advancing Pharmacogenomics from Single-Gene to Preemptive Testing.Annual review of genomics and human genetics · 2022Review
- Pharmacogenomic Clinical Decision Support: A Review, How-to Guide, and Future Vision.Clinical pharmacology and therapeutics · 2022Review
- Perspectives from the Society for Pediatric Research: pharmacogenetics for pediatricians.Pediatric research · 2022Review
- Drug Design: Where We Are and Future Prospects.Molecules (Basel, Switzerland) · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors at 4 institutions in 2 countries.
Funding
Abstract
After postoperative deaths in children who were prescribed codeine, several pediatric hospitals have removed it from their formularies. These deaths were attributed to atypical cytochrome P450 2D6 (CYP2D6) pharmacogenetics, which is also implicated in poor analgesic response. Because codeine is often prescribed to patients with sickle cell disease and is now the only Schedule III opioid analgesic in the United States, we implemented a precision medicine approach to safely maintain codeine as an option for pain control. Here we describe the implementation of pharmacogenetics-based codeine prescribing that accounts for CYP2D6 metabolizer status. Clinical decision support was implemented within the electronic health record to guide prescribing of codeine with the goal of preventing its use after tonsillectomy or adenoidectomy and in CYP2D6 ultra-rapid and poor metabolizer (high-risk) genotypes. As of June 2015, CYP2D6 genotype results had been reported for 2468 unique patients. Of the 830 patients with sickle cell disease, 621 (75%) had a CYP2D6 genotype result; 7.1% were ultra-rapid or possible ultra-rapid metabolizers, and 1.4% were poor metabolizers. Interruptive alerts recommended against codeine for patients with high-risk CYP2D6 status. None of the patients with an ultra-rapid or poor metabolizer genotype were prescribed codeine. Using genetics to tailor analgesic prescribing retained an important therapeutic option by limiting codeine use to patients who could safely receive and benefit from it. Our efforts represent an evidence-based, innovative medication safety strategy to prevent adverse drug events, which is a model for the use of pharmacogenetics to optimize drug therapy in specialized pediatric populations.
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What OpenQuestion holds
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.