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See also comment(s) by Rand Allingham •
OBJECTIVES: To determine whether candidate pharmacodynamic (β-adrenergic receptor) and pharmacokinetic (cytochrome P450 2D6) gene polymorphisms are associated with the intraocular pressure (IOP) response to topical β-blockers. METHODS: Medical records of 18,773 adults in the Personalized Medicine Research Project were searched to extract all IOP measurements for subjects who had been prescribed a topical β-blocker. Five single-nucleotide polymorphisms in the β1-, β2-, and β3-adrenergic receptor genes and 6 polymorphisms in the CYP2D6 gene were genotyped. RESULTS: A total of 58.1% of the subjects were female; the mean age was 63.8 years. Topical β-blockers were prescribed for 343 eyes of 215 subjects. An IOP reduction of 20% or more in 1 or both eyes was observed in 61.0% of subjects. Men were significantly more likely than women to have an IOP decrease of 20% or more (69.3% vs 54.9%, respectively; Χ2 = 4.48; P = .04). After adjusting for sex, family history of glaucoma, and use of systemic β-blockers, subjects with the CC genotype at coding single-nucleotide polymorphism rs1042714 in the ADRB2 gene were significantly more likely to experience an IOP decrease of 20% or more (odds ratio, 2.00; 95% confidence interval, 1.00-4.02). CONCLUSION: We found that a coding single-nucleotide polymorphism in ADRB2 is associated with an increased likelihood of a clinically meaningful IOP response to topical β-blockers. Clinical Relevance Because topical β-blockers are the least expensive class of agents used to lower IOP, genotype-based drug prescribing could save health care dollars.
Dr. C.A. McCarty, Center for Human Genetics, Marshfield Clinic Research Foundation, 1000 N Oak Ave, Marshfield, WI 54449, USA. Mccarty.catherine@mcrf.mfldclin.edu
11.3.4 Betablocker (Part of: 11 Medical treatment > 11.3 Adrenergic drugs)
3.4.2 Gene studies (Part of: 3 Laboratory methods > 3.4 Molecular genetics)