A recent randomized study suggests that Pharmacogenomics testing could be used effectively to customize postoperative pain medicine following total joint replacement. The results of this study, which included 107 patients, were published in The Journal of Arthroplasty.
Pharmacogenomics testing was performed on the patients for about 16 genetic variants, which would affect the pharmacodynamics and pharmacokinetics of non-steroidal anti-inflammatory drugs and many opioids. The patients were randomized into control group or custom group. The control group was prescribed medicines (oxycodone, tramadol, and celecoxib)for postoperative pain management. If any of these drugs were not normally metabolized, they were not prescribed to the patients in the custom group, instead were given alternative drugs (hydromorphone for narcotics, meloxicam for non-steroidal anti-inflammatory drugs). These medicines were taken for the first 10 days post-surgery, and patients recorded their pain level.
Patients in the control group with genetic variants demonstrated a higher average pain level than the custom group. The control group patients consumed more milligram morphine equivalents of pain medication than the custom group.
Thus, custom postoperative pain prescriptions based on pharmacogenetic testing can be utilized to reduce pain levels as well as the intake of pain management medications.