SynthesisBritish journal of clinical pharmacology2020
CYP2D6 polymorphism and its impact on the clinical response to metoprolol: A systematic review and meta-analysis.
Synthesis in British journal of clinical pharmacology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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
32 citing papers in PubMed, 3 syntheses or guidelines pooled it, 56 citations in OpenAlex.
- Clinical Pharmacogenetics Implementation Consortium Guideline (CPIC) for CYP2D6, ADRB1, ADRB2, ADRA2C, GRK4, and GRK5 Genotypes and Beta-Blocker Therapy.Clinical pharmacology and therapeutics · 2024Guideline
- Clinical Pharmacokinetics of Metoprolol: A Systematic Review.Clinical pharmacokinetics · 2022Pooled it
- CYP2D6 polymorphism and its impact on the clinical response to metoprolol: A systematic review and meta-analysis.British journal of clinical pharmacology · 2020Pooled it
- Association of prior beta-blocker treatment and outcome in patients with out-of-hospital cardiac arrest.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Observational
- CYP2D6 as an Emerging Endogenous Oxidative Stress Modulator in Cardiovascular Disease: Genetic, Pharmacological, and Redox Perspectives.Antioxidants (Basel, Switzerland) · 2026Review
- CYP2D6 Metabolizer Status and Mortality in Metoprolol Users.Clinical and translational science · 2026Article
- Cytochrome P450 2D6 Metabolizer Phenotype Is Associated With Metoprolol Pharmacodynamics But Not With Metoprolol Discontinuation: A Retrospective Cohort Study in the All of Us Research Program.Journal of clinical medicine research · 2026Article
- Metoprolol Population Pharmacokinetics in Older Chinese Patients With CKM Syndrome: Joint Effects of rs1065852 and CKMClinical and translational science · 2026Article
- CYP450 Metabolizer Phenotypes in a Turkish Emergency Cardiac Patient Cohort: A Descriptive Pharmacogenomic Study.Pharmaceuticals (Basel, Switzerland) · 2026Article
- Article
- The evolving landscape of pharmacogenomics: Current achievements and future directions.Pharmacological reviews · 2026Review
- Pharmacometabolomics Detects Various Unreported Metoprolol Metabolites in Urine of (Potential) Living Kidney Donors and Kidney Transplant Recipients.Clinical pharmacokinetics · 2025Article
- Distribution of Cytochrome P450 2D6 (*4, *9, *10, *41) alleles in healthy population from north-west of Iran.ARYA atherosclerosis · 2025Article
- Population-specific genetic differences of acute coronary syndrome in Han and Uyghur Chinese.Frontiers in pharmacology · 2025Article
- PBPK Modeling of Lamotrigine and Efavirenz during Pregnancy: Implications for Personalized Dosing and Drug-Drug Interaction Management.Pharmaceutics · 2024Article
- Association of Antihypertensive Drug-Related Gene Polymorphisms with Stroke in the Chinese Hypertensive Population.International journal of hypertension · 2024Article
- Comparison between the ECG Outcomes of Metoprolol and Bisoprolol.Cardiovascular & hematological agents in medicinal chemistry · 2024Article
- Comparative Analysis of Machine Learning Algorithms Evaluating the Single Nucleotide Polymorphisms of Metabolizing Enzymes with Clinical Outcomes Following Intravenous Paracetamol in Preterm Neonates with Patent Ductus Arteriosus.Current drug metabolism · 2024Observational
- Impact of amiodarone use on metoprolol concentrations, α-OH-metoprolol concentrations, metoprolol dosing and heart rate: A cross-sectional study.Pharmacology research & perspectives · 2023Article
- Application of Advanced Technologies-Nanotechnology, Genomics Technology, and 3D Printing Technology-In Precision Anesthesia: A Comprehensive Narrative Review.Pharmaceutics · 2023Review
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsCYP2D6 genetic polymorphisms are associated with metoprolol pharmacokinetics. Whether the clinical response to metoprolol is also affected remains uncertain.
methodsWe conducted a systematic review on the effects of CYP2D6 polymorphism on the clinical response to metoprolol. Searches were conducted using MEDLINE. Meta-analyses were performed on the impact of CYP2D6-inferred phenotypes on heart rate (HR) reduction, diastolic (DBP) and systolic (SBP) blood pressure reduction, average daily doses, all-type adverse events and bradycardia.
resultsOur qualitative assessment indicated inconsistent results in individual studies and endpoints, but CYP2D6 poor metabolizers (PM) generally presented a greater reduction in HR. The meta-analysis of 15 studies, including a total of 1146 individuals, found a reduction in HR of 3 beats/min (P = .017), and of SBP and DBP by 3 mmHg (P = .0048) for PM compared to non-PM individuals using similar metoprolol doses. Bradycardia appeared more frequent by 4-fold for PM, although significant heterogeneity was observed regarding bradycardia, which limits the scope of this finding.
conclusionPatients without any CYP2D6 metabolic capacities appear to have increased reduction in DBP, HR and SBP during metoprolol treatment and may be at a higher risk of bradycardia compared to patients with active CYP2D6 phenotypes. Further prospective data are required to determine whether CYP2D6 is associated with clinical events in patients treated with metoprolol, as well as to demonstrate the clinical utility of an individualized approach of prescribing metoprolol using CYP2D6-inferred phenotypes.
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