The PRESIDE (PhaRmacogEnomicS In DEpression) Trial: a double-blind randomised controlled trial of pharmacogenomic-informed prescribing of antidepressants on depression outcomes in patients with major depressive disorder in primary care.

Journal: Trials

Volume: 24

Issue: 1

Year of Publication: 2023

Affiliated Institutions:  Department of General Practice and Primary Care, Melbourne Medical School, University of Melbourne, Melbourne, Australia. sibel.saya@unimelb.edu.au. Department of General Practice and Primary Care, Melbourne Medical School, University of Melbourne, Melbourne, Australia. School of Public Health and Preventive Medicine, Monash University Health Economics Group, Monash University, Melbourne, VIC, Australia. Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, , Australia. , Certara, Princeton, NJ, USA. Genetics Department, Douglass Hanly Moir Pathology, Sonic Healthcare, Sydney, NSW, Australia. Translational Software, Mercer Island, WA, USA. Department of Medical Genetics, University of Calgary, Calgary, AB, Canada.

Abstract summary 

The evidence for the clinical utility of pharmacogenomic (PGx) testing is growing, and guidelines exist for the use of PGx testing to inform prescribing of 13 antidepressants. Although previous randomised controlled trials of PGx testing for antidepressant prescribing have shown an association with remission of depression in clinical psychiatric settings, few trials have focused on the primary care setting, where most antidepressant prescribing occurs.The PRESIDE Trial is a stratified double-blinded randomised controlled superiority trial that aims to evaluate the impact of a PGx-informed antidepressant prescribing report (compared with standard prescribing using the Australian Therapeutic Guidelines) on depressive symptoms after 12 weeks, when delivered in primary care. Six hundred seventy-two patients aged 18-65 years of general practitioners (GPs) in Victoria with moderate to severe depressive symptoms, measured using the Patient Health Questionnaire-9 (PHQ-9), will be randomly allocated 1:1 to each arm using a computer-generated sequence. Participants and GPs will be blinded to the study arm. The primary outcome is a difference between arms in the change of depressive symptoms, measured using the PHQ-9 after 12 weeks. Secondary outcomes include a difference between the arms in change in PHQ-9 score at 4, 8 and 26 weeks, proportion in remission at 12 weeks, a change in side effect profile of antidepressant medications, adherence to antidepressant medications, change in quality of life and cost-effectiveness of the intervention.This trial will provide evidence as to whether PGx-informed antidepressant prescribing is clinically efficacious and cost-effective. It will inform national and international policy and guidelines about the use of PGx to select antidepressants for people with moderate to severe depressive symptoms presenting in primary care.Australian and New Zealand Clinical Trial Registry ACTRN12621000181808. Registered on 22 February 2021.

Authors & Co-authors:  Saya Sibel S Chondros Patty P Abela Anastasia A Mihalopolous Cathrine C Chatterton Mary Lou ML Gunn Jane J Chen Timothy F TF Polasek Thomas M TM Dettmann Elise E Brooks Rachel R King Michelle M Spencer Luke L Alphonse Pavithran P Milton Shakira S Ramsay Georgia G Siviour Zoe Z Liew Jamie J Ly Philip P Thoenig Matthew M Seychell Raushaan R La Rocca Floriana F Hesson Luke B LB Mejias Nydia N Sivertsen Terri T Galea Melanie Anne MA Bousman Chad C Emery Jon J

Study Outcome 

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Statistics
Citations :  James SL, Abate D, Abate KH, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990–2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2018;392(10159):1789–1858. doi: 10.1016/S0140-6736(18)32279-7.
Authors :  27
Identifiers
Doi : 342
SSN : 1745-6215
Study Population
Male,Female
Mesh Terms
Humans
Other Terms
Antidepressants;General practice;Major depressive disorder;Mental health;Pharmacogenomics;Primary care;Randomised controlled trial
Study Design
Study Approach
Country of Study
Publication Country
England