CYP2D6 metabolism in frail elderly compared to non-frail elderly

F.L. Opdam, A.S. Modak, S.P. Mooijaart, M.W.M. de Waal, M. Louwerens, H. Gelderblom, H.J. Guchelaar

Voorzitter(s): prof. dr. R.P. Koopmans, MUMC, Maastricht & dr. C.J.A.M. Konings, Catharina Ziekenhuis, Eindhoven

Woensdag 22 april 2015

15:00 - 16:00u in Zaal 2.1

Categorieën: parallelsessie (case reports/research)

Parallel sessie: Parallelsessie 5: Case reports/research

Background:
 Frailty is a clinical phenotype that is associated with adverse health outcomes. Since frail patients might be prone for adverse drugs events and about 15-20% of commonly prescribed drugs are metabolized by CYP2D6, it was hypothesized that CYP2D6 metabolism is altered in frail patients compared to healthy subjects.

Methods:
 The 13C-dextromethorphan breath test (13C-DM-BT) was used to determine CYP2D6 phenotype using 13C-dextromethorphan (13C-DM) as a probe. Eleven frail and twenty-two non-frail (according to the Fried criteria) subjects aged 70-85 years were phenotyped for CYP2D6.

Results:
 Frailty score and individual parameters of frailty, Karnofsky score, HADS score and ADL score were not whereas length, weight and BMI were significantly correlated to CYP2D6 phenotype. There was no difference in CYP2D6 phenotype between frail (AUCDOB2h 319 ± 169”min) and non-frail subjects (AUCDOB2h 298 ± 159”min, p=0.728), even when corrected for BMI. We observed higher CYP2D6 metabolism in women (AUC DOB2h 362 ± 162 “min) compared to men (AUC DOB2h 252 ± 142 “min, p=0.036), independent of frailty in the selected age group.

Conclusion:
 Frail and non-frail subjects did not differ in CYP2D6 phenotype. Our study does not suggest a role for CYP2D6 in explaining why frail subjects are more sensitive to adverse drug reactions.

 

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