Observational studyJournal of burn care & research : official publication of the American Burn Association2019
Identification of Cytochrome P450 Polymorphisms in Burn Patients and Impact on Fentanyl Pharmacokinetics: A Pilot Study.
Observational study in Journal of burn care & research : official publication of the American Burn Association, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 2 of them syntheses 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
13 citing papers in PubMed, 2 syntheses or guidelines pooled it, 14 citations in OpenAlex.
- Pharmacogenetic Evidence in Opioid-Related Toxicity and Death with an Appraisal of Emerging Multi-Omics Studies: A Systematic Review.International journal of molecular sciences · 2026Pooled it
- American Burn Association Guidelines on the Management of Acute Pain in the Adult Burn Patient: A Review of the Literature, a Compilation of Expert Opinion, and Next Steps.Journal of burn care & research : official publication of the American Burn Association · 2020Guideline
- Advances in pharmacokinetic-pharmacodynamic modeling for anesthesia, 1987-2024: a review.Frontiers in pharmacology · 2026Review
- Pharmacogenomic variation and sedation outcomes during early intensive care unit admission: A pragmatic study.Clinical and translational science · 2024Observational
- Review
- Leveraging in Vitro Models for Clinically Relevant RareDrug metabolism and disposition: the biological fate of chemicals · 2024Review
- Article
- State and Future Science of Opioids and Potential of Biased-ligand Technology in the Management of Acute Pain After Burn Injury.Journal of burn care & research : official publication of the American Burn Association · 2023Review
- Pharmacogenomics of Cancer Pain Treatment Outcomes in Asian Populations: A Review.Journal of personalized medicine · 2022Review
- Pharmacogenetic Gene-Drug Associations in Pediatric Burn and Surgery Patients.Journal of burn care & research : official publication of the American Burn Association · 2022Article
- Cerebral Edema in Traumatic Brain Injury: a Historical Framework for Current Therapy.Current treatment options in neurology · 2020Article
- Characterizing Fentanyl Variability Using Population Pharmacokinetics in Pediatric Burn Patients.Journal of burn care & research : official publication of the American Burn Association · 2020Observational
- Scoping review of associations between cytochrome P450 3A4/5 single nucleotide polymorphisms and risk factors for fentanyl overdose.PharmacogenomicsArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
Pain management is critical for burn care. Unfortunately, interindividual variation in pharmacokinetics (PK) due to burn hypermetabolism and genetic polymorphisms can lead to treatment failures in this at-risk population. Analgesics may be affected by genetic polymorphisms affecting cytochrome P450 (CYP) drug metabolizing enzymes. Fentanyl is a common opiate primarily metabolized by CYP3A4 subtypes. Recent studies demonstrate CYP2D6 variants, affecting fentanyl PK. Functional CYP polymorphisms can significantly alter opiate levels resulting in inadequate analgesia or life-threatening toxicity. The goal of our study was to evaluate fentanyl PK and assess associations with CYP polymorphisms. We obtained samples from the previously banked blood of 13 patients (eight males and five females) with >20% TBSA burns. Mean (SD) patient age was 41.7 (14.5) years, and mean burn size was 25.8 (15.3) %TBSA. Plasma fentanyl was quantified, and CYP genotyping was performed. Pharmacokinetic analysis was performed using Monolix software (Lixsoft, France) with a two-compartment population model best-representing fentanyl profiles. Three CYP slow-metabolizing genotypes were identified, which included CYP2D6*9, CYP2D6*29, and CYP3A4*1B. All three patients with variant polymorphisms had increased serum fentanyl concentrations due to impaired clearance. This pilot study supports the need for further research in this topic, and CYP genotyping of individual patients prior to receiving opiate analgesics to inform precision-guided decisions, improve therapeutic efficacy, and, most importantly, increase patient well-being and safety.
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Registered trials
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