Rescue morphine in mechanically ventilated newborns associated with combinedOPRM1andCOMTgenotype

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Abstract

Aim:

Determine whether SNPs of OPRM1 118A>G (asn40asp), COMT 472G>A (val158met) and ARRB2 8622C>T are associated with morphine rescue in newborns on mechanical ventilation.

Materials & methods:

This is a pharmacogenetic analysis of a randomized controlled trial in (pre)term newborns (n = 64) at a level III Neonatal Intensive Care Unit (NICU) who received placebo infusion and for whom need and dose for rescue morphine was documented.

Results:

For OPRM1 and COMT separately, the expected risk for rescue morphine or morphine dose was not significantly increased. However, the combined OPRM1/COMT ‘high-risk’ genotype lead to a significant association with the need for rescue (OR: 5.12; 95% CI: 1.12–23.3; p = 0.035). No association was found between OPRM1/COMT ‘high-risk’ genotype and total morphine dose administered.

Conclusion:

Combined OPRM1 118A>G and COMT 472G>A genotype might serve as a predictor for the need of rescue morphine in premature and term newborns on mechanical ventilation.

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