Trial reportGenetics in medicine : official journal of the American College of Medical Genetics2021
A hybrid implementation-effectiveness randomized trial of CYP2D6-guided postoperative pain management.
Trial report in Genetics in medicine : official journal of the American College of Medical Genetics, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03534063 (Implementing Genomics in Practice), which is not on this map. Cited by 26 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.
Implementing Genomics in Practice (IGNITE): CYP2D6 Genotype-Guided Pain Management in Patients Undergoing Arthroplasty Surgery
Who cites it
26 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Pharmacogenomic-guided opioid therapy for pain: a systematic review and meta-analysis of randomised controlled trials.The pharmacogenomics journal · 2025Pooled it
- Pooled it
- CYP2D6-Guided Opioid Management and Postoperative Pain Control: A Randomized Clinical Trial.JAMA network open · 2026Trial
- A Randomized Hybrid-Effectiveness Trial Comparing Pharmacogenomics (PGx) to Standard Care: The PGx Applied to Chronic Pain Treatment in Primary Care (PGx-ACT) Trial.Clinical and translational science · 2025Trial
- CYP2D6-guided opioid therapy for adults with cancer pain: A randomized implementation clinical trial.Pharmacotherapy · 2023Trial
- Pharmacogenetic Guided Opioid Therapy Improves Chronic Pain Outcomes and Comorbid Mental Health: A Randomized, Double-Blind, Controlled Study.International journal of molecular sciences · 2023Trial
- Integration of Precision Medicine into ERAS Pathways: A Conceptual Framework, Current Feasibility and Challenges.Journal of personalized medicine · 2026Review
- Personalized Multimodal and Opioid-Sparing Analgesia for Postoperative Pain Management: Enhancing Recovery and Addressing the Post-Discharge Gap.Journal of pain research · 2026Review
- Multi-Gene Pharmacogenomic Testing in a Community-Based Setting Is Feasible and Reduces Total Healthcare Costs.Clinical and translational science · 2025Article
- Pharmacogenetics: Opportunities for theAnnual review of pharmacology and toxicology · 2025Review
- The Perioperative Use of Codeine and Tramadol in Pediatric Population.Translational perioperative and pain medicine · 2025Article
- Associations between (pharmaco-)genetic markers and postoperative pain after inguinal hernia repair - a prospective study protocol.BMC medical genomics · 2024Article
- Chronic postsurgical pain (CPSP): an underestimated problem after incisional hernia treatment.Hernia : the journal of hernias and abdominal wall surgery · 2024Article
- Implementing a pragmatic clinical trial to tailor opioids for chronic pain on behalf of the IGNITE ADOPT PGx investigators.Clinical and translational science · 2024Article
- Pharmacogenetic Approaches in Personalized Medicine for Postoperative Pain Management.Biomedicines · 2024Review
- Catalyzing Pharmacogenomic Analysis for Informing Pain Treatment (C-PAIN): A Randomized Trial of PreemptiveJournal of pain research · 2024Article
- Estimated clinical utility of multi-gene pharmacogenetic testing in a retrospective cohort of gynecology patients.Pharmacogenomics · 2024Article
- Precision Medicine in Oral Health and Diseases: A Systematic Review.Journal of personalized medicine · 2023Review
- Case Report: Performing a Medication Safety Review Assisted by Pharmacogenomics to Explain a Prescribing Cascade Resulting in a Patient Fall.Medicina (Kaunas, Lithuania) · 2023Article
- Association ofAnnals of translational medicine · 2022Article
Corrections and comments
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Authors and funding
13 authors.
Funding
Abstract
purposeCytochrome P450 2D6 (CYP2D6) genotype-guided opioid prescribing is limited. The purpose of this type 2 hybrid implementation-effectiveness trial was to evaluate the feasibility of clinically implementing CYP2D6-guided postsurgical pain management and determine that such an approach did not worsen pain control.
methodsAdults undergoing total joint arthroplasty were randomized 2:1 to genotype-guided or usual pain management. For participants in the genotype-guided arm with a CYP2D6 poor (PM), intermediate (IM), or ultrarapid (UM) metabolizer phenotype, recommendations were to avoid hydrocodone, tramadol, codeine, and oxycodone. The primary endpoints were feasibility metrics and opioid use; pain intensity was a secondary endpoint. Effectiveness outcomes were collected 2 weeks postsurgery.
resultsOf 282 patients approached, 260 (92%) agreed to participate. In the genotype-guided arm, 20% had a high-risk (IM/PM/UM) phenotype, of whom 72% received an alternative opioid versus 0% of usual care participants (p < 0.001). In an exploratory analysis, there was less opioid consumption (200 [104-280] vs. 230 [133-350] morphine milligram equivalents; p = 0.047) and similar pain intensity (2.6 ± 0.8 vs. 2.5 ± 0.7; p = 0.638) in the genotype-guided vs. usual care arm, respectively.
conclusionImplementing CYP2D6 to guide postoperative pain management is feasible and may lead to lower opioid use without compromising pain control.
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Registered trials
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