Pilot RCT in veterans with depression finds no benefit from immediate PGx testing.

This pilot randomized clinical trial involved 60 veterans with depression, comparing immediate availability of pharmacogenomic (PGx) test results to delayed results until the end of the 12-week trial. The primary outcome was PHQ-9 scores, with secondary outcomes including the proportion of patients with medication changes and time to first medication change. Over a follow-up of 2.8 months, no significant differences were observed in PHQ-9 scores, the proportion of patients with medication changes, or time to first medication change. However, 30% of subjects had an actionable gene-drug interaction, indicating potential genetic relevance in this population.

Safety and tolerability data were not reported, including adverse events, serious adverse events, and discontinuations. Key limitations include low rates of actionable gene-drug interactions, which may have influenced the modest outcomes, and the pilot nature of the study, which limits generalizability and certainty.

Practice relevance is restrained: targeted PGx testing can increase rates of actionable genotypes in patients with depression, but this trial did not show clinical benefits from immediate testing. Clinicians should interpret these findings cautiously due to the small sample size, short follow-up, and lack of detailed safety information, considering PGx testing as an exploratory tool rather than a standard intervention in this context.