曲马多,临床注释,变异和临床注释数据

曲马多

临床注释ID

1451154980

药物名称(英)

tramadol

变异单倍型

CYP2D6*1, CYP2D6*3, CYP2D6*4, CYP2D6*5, CYP2D6*6, CYP2D6*10, CYP2D6*17

基因

CYP2D6

证据级别

水平覆盖

水平修饰符

Tier 1 VIP

表现型类别(英)

Efficacy

表现型类别

功效

分数

233.25

PMID计数

计数的证据

表现型

疼痛；疼痛，术后

表现型(英)

Pain;Pain, Postoperative

最新日期

2022-01-11

URL

https://www.pharmgkb.org/clinicalAnnotation/1451154980

专业人口(英)

专业人口

临床等位基因

id	等位基因	注释文本
4888	*17	The CYP2D617 allele is assigned as a decreased function allele with an activity value of 0.5 by CPIC. Patients carrying the 17 allele in combination with a decreased or no function allele may have a decreased analgesic response when treated with tramadol as compared to patients with alleles that result in a normal metabolizer phenotype, while patients carrying the *17 allele in combination with an increased function allele may have an increased analgesic response when treated with tramadol as compared to patients with alleles that result in a normal metabolizer phenotype. Other genetic and clinical factors may also influence analgesic response when treated with tramadol.
4887	*10	The CYP2D610 allele is assigned as a decreased function allele with an activity value of 0.25 by CPIC. Patients carrying the 10 allele in combination with a decreased or no function allele may have a decreased analgesic response when treated with tramadol as compared to patients with alleles that result in a normal metabolizer phenotype. Patients carrying the 10 allele in combination with a normal function allele or an increased function allele with an activity value of 2 may have a similar analgesic response when treated with tramadol as compared to patients with alleles that result in a normal metabolizer phenotype, while patients carrying the 10 allele in combination with an increased function allele with an activity value of 3 or greater may have an increased analgesic response when treated with tramadol as compared to patients with alleles that result in a normal metabolizer phenotype. Other genetic and clinical factors may also influence analgesic response when treated with tramadol.
4886	*6	The CYP2D66 allele is assigned as a no function allele by CPIC. Patients carrying the 6 allele in combination with a decreased, normal or no function allele may have a decreased analgesic response when treated with tramadol as compared to patients with alleles that result in a normal metabolizer phenotype. Patients carrying the 6 allele in combination with an increased function allele with an activity value of 2 may have a similar analgesic response when treated with tramadol as compared to patients with alleles that result in a normal metabolizer phenotype, while patients carrying the 6 allele in combination with an increased function allele with an activity value of 3 or greater may have an increased analgesic response when treated with tramadol as compared to patients with alleles that result in a normal metabolizer phenotype. Other genetic and clinical factors may also influence analgesic response when treated with tramadol.
330	*5	The CYP2D65 allele is assigned as a no function allele by CPIC. Patients carrying the 5 allele in combination with a decreased, normal or no function allele may have a decreased analgesic response when treated with tramadol as compared to patients with alleles that result in a normal metabolizer phenotype. Patients carrying the 3 allele in combination with an increased function allele with an activity value of 2 may have a similar analgesic response when treated with tramadol as compared to patients with alleles that result in a normal metabolizer phenotype, while patients carrying the 3 allele in combination with an increased function allele with an activity value of 3 or greater may have an increased analgesic response when treated with tramadol as compared to patients with alleles that result in a normal metabolizer phenotype. Other genetic and clinical factors may also influence analgesic response when treated with tramadol.
329	*4	The CYP2D64 allele is assigned as a no function allele by CPIC. Patients carrying the 4 allele in combination with a decreased, normal or no function allele may have a decreased analgesic response when treated with tramadol as compared to patients with alleles that result in a normal metabolizer phenotype. Patients carrying the 4 allele in combination with an increased function allele with an activity value of 2 may have a similar analgesic response when treated with tramadol as compared to patients with alleles that result in a normal metabolizer phenotype, while patients carrying the 4 allele in combination with an increased function allele with an activity value of 3 or greater may have an increased analgesic response when treated with tramadol as compared to patients with alleles that result in a normal metabolizer phenotype. Other genetic and clinical factors may also influence analgesic response when treated with tramadol.
202	*3	The CYP2D63 allele is assigned as a no function allele by CPIC. Patients carrying the 3 allele in combination with a decreased, normal or no function allele may have a decreased analgesic response when treated with tramadol as compared to patients with alleles that result in a normal metabolizer phenotype. Patients carrying the 3 allele in combination with an increased function allele with an activity value of 2 may have a similar analgesic response when treated with tramadol as compared to patients with alleles that result in a normal metabolizer phenotype, while patients carrying the 3 allele in combination with an increased function allele with an activity value of 3 or greater may have an increased analgesic response when treated with tramadol as compared to patients with alleles that result in a normal metabolizer phenotype. Other genetic and clinical factors may also influence analgesic response when treated with tramadol.
122	*1	The CYP2D61 allele is assigned as a normal function allele by CPIC. Patients carrying the 1 allele in combination with alleles that result in a normal metabolizer phenotype may have a similar analgesic response to tramadol as compared to patients carrying two increased function alleles or an increased function allele in combination with a normal function allele or a decreased function allele with an activity value of 0.5. Patients carrying the *1 allele in combination with alleles that result in a normal metabolizer phenotype may also have a similar analgesic response to tramadol as compared to patients carrying an increased function allele with an activity value of 3 or greater in combination with a no function allele or a decreased function allele with an activity value of 0.25 but an increased analgesic response to tramadol as compared to patients with a no function allele in combination with a decreased or normal function allele or two decreased or no function alleles. Other genetic and clinical factors may also influence analgesic response when treated with tramadol.

临床证据

id	证据的ID	总结
14519	1451638720	CYP2D6 4 is associated with decreased response to tramadol in people with Pain, Postoperative as compared to CYP2D6 1.
14518	1451141860	CYP2D6 5/17 is associated with decreased response to hydrocodone or tramadol in women.
14517	1446898050	CYP2D6 10/10 is associated with increased severity of Pain when treated with tramadol in people with Pain, Postoperative as compared to CYP2D6 1/1 + 1/10.
14516	1183618098	CYP2D6 6/6 is associated with increased risk of non-response and required higher dose when treated with tramadol as compared to CYP2D6 *1.
14515	1183618090	CYP2D6 4/5 is associated with increased risk of non-response and required higher dose when treated with tramadol as compared to CYP2D6 *1.
14514	1183618082	CYP2D6 5/5 is associated with increased risk of non-response and required higher dose when treated with tramadol as compared to CYP2D6 *1.
14507	1183684648	CYP2D6 ultra-metabolizer genotype is associated with increased pain threshold and pain tolerance when treated with tramadol in healthy individuals as compared to CYP2D6 normal metabolizer genotype.
14506	1183617989	CYP2D6 poor metabolizer is associated with decreased metabolism of tramadol and decreased response to tramadol when treated with tramadol as compared to CYP2D6 normal metabolizer.
14505	PA166104959	Annotation of DPWG Guideline for tramadol and CYP2D6
14504	PA166228101	Annotation of CPIC Guideline for tramadol and CYP2D6
14428	1183618069	CYP2D6 3/5 is associated with increased risk of non-response and required higher dose when treated with tramadol as compared to CYP2D6 *1.
14427	1183618060	CYP2D6 4/4 is associated with increased risk of non-response and required higher dose when treated with tramadol as compared to CYP2D6 *1.
14426	1183618052	CYP2D6 4/4 is associated with decreased metabolism and decreased response to tramadol when treated with tramadol as compared to CYP2D6 *1.
14425	1183618044	CYP2D6 3/5 is associated with decreased metabolism and decreased response to tramadol when treated with tramadol as compared to CYP2D6 *1.
14424	1183618035	CYP2D6 3/4 is associated with decreased metabolism and decreased response to tramadol when treated with tramadol as compared to CYP2D6 *1.
14423	1183617913	CYP2D6 4/6 is associated with intolerance to oxycodone and tramadol ( significant side effects as well as no pain relief) when treated with oxycodone and tramadol.
14422	1451645100	CYP2D6 poor metabolizers and intermediate metabolizers are associated with decreased response to codeine, fentanyl, hydrocodone, hydromorphone, methadone, morphine, oxycodone or tramadol in people with Neoplasms and Pain as compared to CYP2D6 normal metabolizers.
14421	1451406280	CYP2D6 ultrarapid metabolizer genotype is associated with increased response to tramadol in people with Pain, Postoperative as compared to CYP2D6 poor metabolizer and intermediate metabolizer genotypes.
14420	1451205845	CYP2D6 poor metabolizer is associated with increased response to tramadol in people with Pain, Postoperative as compared to CYP2D6 normal metabolizer and ultrarapid metabolizer.
14419	1451155685	CYP2D6 poor metabolizer phenotype is associated with increased response to tramadol in people with Phantom limb syndrome as compared to CYP2D6 normal metabolizer phenotype.
14418	1450376074	CYP2D6 poor metabolizer is associated with increased likelihood of Pain when treated with codeine or tramadol in people with Pain as compared to CYP2D6 normal metabolizer.
14417	1450376063	CYP2D6 poor and ultrarapid metabolizers is associated with increased likelihood of discontinuation when treated with codeine or tramadol in people with Pain as compared to CYP2D6 normal metabolizer.

临床病史

id	类型	评论
92	Update	Added PMID 34423496 to evidence.
91	Update	Added PMID 34246203 to evidence.
90	Update	Added DPWG guideline as evidence
89	Update	Added PMID 33812699 to evidence
88	Update	CA score added as part of scoring system release. LOE assigned following curator review.
87	Update	Minor edits to phenotype descriptions
86	Update	Minor edits to phenotype descriptions
85	Update	Added CPIC guideline and rewrote phenotype descriptions.
84	Update	Added PMID 22528763 to evidence and updated phenotype descriptions
83	Update	Minor edits to phenotype descriptions
82	Update	Added PMID 16129989 to evidence and updated phenotype descriptions
81	Create	Created

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