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Prevalence and implications of cytochrome P450 substrates in Massachusetts hospital discharges

The Pharmacogenomics Journal volume 17, pages 382–385 (2017)Cite this article

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Abstract

The cytochrome P450 (CYP450) system of drug-metabolizing enzymes may contribute to individual variation in drug response. We examined prevalence of CYP450 substrates at hospital discharge for patients in two cohorts: insurance claims of Massachusetts residents and the medical records of two academic medical centers. The claims cohort included 47 473 individuals (38.2%) treated with at least one CYP450 2D6, 2C19, 3A4 or 1A2 substrate. The electronic medical records cohort included 45 905 individuals (57.4%) treated with at least one substrate. In adjusted models, substrates of CYP450 2D6 and 2C19 were associated with greater risk for 90-day readmission in both cohorts (odds ratios of 1.104 and 1.128 (P<0.001), respectively). Presence of any CYP450 substrate was associated with increased monthly medical costs (+$397, P<0.003). These analyses of more than 300 000 admissions using two different cohorts and data types indicate that CYP450 substrates are associated with greater readmission rates and greater health-care cost.

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Acknowledgements

Outside funding was not received for this study. We acknowledge the assistance of Massachusetts Department of Health staff in the generation of the All-Payer Claims Database.

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Authors and Affiliations

  1. Department of Psychiatry, Center for Experimental Drugs and Diagnostics, Massachusetts General Hospital, Boston, MA, USA

    T H McCoy, V M Castro, A Cagan, A M Roberson & R H Perlis

  2. Department of Psychiatry, Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, MA, USA

    T H McCoy, A M Roberson & R H Perlis

  3. Partners Research Computing, Partners HealthCare System, One Constitution Center, Boston, MA, USA

    V M Castro & A Cagan

  4. Laboratory of Computer Science and Department of Neurology, Massachusetts General Hospital, Boston, MA, USA

    V M Castro & A Cagan

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  1. T H McCoy
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Correspondence to R H Perlis.

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Competing interests

RHP has served on advisory boards or provided consulting to Genomind, Healthrageous, Perfect Health, Pfizer, Psybrain and RIDVentures. The other authors declare no conflict of interest.

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McCoy, T., Castro, V., Cagan, A. et al. Prevalence and implications of cytochrome P450 substrates in Massachusetts hospital discharges. Pharmacogenomics J 17, 382–385 (2017). https://doi.org/10.1038/tpj.2016.24

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